Job DescriptionThe Managed Care and Value Based Contract Manager is responsible for contract management including negotiation, analysis interpretation, implementation, maintenance of the contract performance, and payer relations. The position coordinates, evaluates and oversees implementation of fee for service and value-based contracting and related responsibilities, population health/clinical integration, strategies, government contracts and partnering opportunities with regional employers. The position is responsible for coordination and communication between all key stakeholders and for developing new and existing relationships with third party payers to ensure competitive agreements to ensure best possible reimbursement methodologies. This position will build and maintain a strong functional Managed Care team through effective training, coaching, team building and succession planning.
Responsibilities- Build and maintain a strong functional Managed Care team through effective training, coaching, team building and succession planning.
- Developing and implementing strategies to improve the quality and efficiency of healthcare services provided.
- Negotiating contracts and agreements with healthcare providers and payers to align incentives with value-based care goals.
- Collaborating with payers to establish and monitor performance metrics and outcomes.
- Monitoring and evaluating the effectiveness of value-based care programs and interventions; Facilitating communication and coordination among different healthcare providers and settings to promote continuity of care.
- Identifying and implementing evidence-based practices and interventions to improve patient outcomes and satisfaction. Continuously seeking opportunities for innovation and improvement in the delivery of healthcare services.
- All other duties as assigned
Qualifications- Bachelor's Degree.
- 3 - 5 Years equivalent experience.
