Responsibilities
Ernest Health is growing!! New Managed Care Manager position available in the Mountain States.
The Managed Care Contracting Manager is responsible for system-wide managed care contracting including negotiation/re-negotiation of language and reimbursement terms. Serves as the liaison between Managed Care Organizations and Company. Provides support and communicates contract terms and reimbursement methodologies to hospitals and clinics in order to maximize managed care contract performance. Assists hospitals and support staff with payor issues and discrepancies related to contract terms to create a seamless operational performance. If needed, perform credentialing and re-credentialing according to plan specifications in a timely, accurate fashion. Track all performance for reporting purposes.
Required Skills:- Minimum three (3) years' experience required in managed care contracting, negotiations/renegotiations, provider relations, and the healthcare industry.
- Knowledge of Mountain States markets is required.
- Preferrable candidate will reside in Western states.
- Bachelor's Degree preferred OR any equivalent combination of education and experience.
- Strong negotiating skills.
- Knowledge of managed care procedures and laws required.
- Knowledge of Federal and State healthcare regulations pertaining to Medicare, Medicaid required.
- Ability to communicate (both written and orally) with senior management, business office, marketing, case management, and managed care organizations is required.
Additional Qualifications/Skills:- Strong interpersonal skills and partnership skills to include negotiation.
- High degree of accuracy and attention to detail.
- Discretion in dealing with sensitive confidential information.
- Demonstrates honesty and integrity at all times.
- Ability to carry out duties with limited supervision.
- Knowledge of regulatory standards and compliance requirements.
- Demonstrates general computer skills including data entry, word processing, email, and record management.
- Ability to meet deadlines.
- Ability to prioritize and multi-task.
- Effective organizational and time management skills.
- Effective written and verbal communication skills.
- Ability to maintain quality and safety standards.
- Ability to project a professional image.
- Ability to work closely and professionally with others.
