Caresource

Mgr HP Contracting & Service - GA

Caresource$83K — $132K *
US-AnywhereRemote in Georgia, US
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's Degree in Business Administration or related field or equivalent work experience
  • Minimum of three years in healthcare or managed care
  • Experience in provider relations or contracting
  • Previous management experience preferred

Responsibilities

  • Track and analyze contracting trends and priorities
  • Assist in developing team strategic direction and annual goals
  • Establish relationships with internal and external partners
  • Lead cross-functional teams for key contracts
  • Conduct project meetings and manage project plans
  • Manage daily operations including hiring, training, and performance management
  • Report on initiatives and key accomplishments to leadership

Benefits

  • Comprehensive total rewards package
  • Opportunities for performance-related bonuses
  • Support for employee well-being
  • Potential for professional development
  • Flexible work environment
Full Job Description
Job Summary:

The Manager, Market Contracting is responsible for assisting the Director, and managing a team, to manage and negotiate assigned contracts including analysis of the contract proposals and conducting financial impact to make informed decisions as well as support activities related to quality and affordability initiatives (QAIs).

Essential Functions:
  • Responsible for tracking and trending, contracting trends, inventory, and priorities
  • Assists with the development and evolution of the team's strategic direction, annual goals, and objectives; recommends new processes and changes for increased department productivity to ensure appropriate network adequacy and access across all products
  • Establish and maintain strong working relationships with key internal and external business partners
  • Develop and report on key accomplishments and issues to upper management
  • Lead cross-functional workgroups for special priority contracts, create and manage work plans, and facilitate the removal of barriers to ensure timely implementation of key contracts and providers
  • Conduct project team meetings to establish and execute on detailed project plans
  • Report on key initiatives and accomplishments to leadership, including PowerPoint report outs
  • Ensure proper documentation and standard operating procedures (SOPs) are followed by staff
  • Implement and maintain key metrics for staff performance
  • Manage day to day operations of direct reports, to include hiring decisions, performance management, training, and staff development
  • Participate in network provider meetings, attend key committees, subcommittees, and/or workgroups as necessary
  • Manage multiple projects; collect and analyze data and disseminate to appropriate departments as necessary
  • Ensure appropriate documentation of interactions and projects by all team members
  • Coordinate contract language change requests to ensure template accuracy and utilization
  • Perform any other job duties as requested


Education and Experience:
  • Bachelor's Degree in Business Administration or related field, or equivalent years of relevant work experience is required, or combination of education and related work experience
  • A minimum of three (3) years of progressive experience in health care or managed care is required
  • Experience in provider relations or contracting is required
  • Previous management experience is preferred


Competencies, Knowledge and Skills:
  • Proficient with Microsoft Office to include Word, Excel and PowerPoint
  • Excellent written and verbal communications skills
  • Ability to develop, prioritize and accomplish goals
  • Detail oriented
  • Strong interpersonal skills and high level of professionalism
  • Effective listening and critical thinking skills
  • Effective problem-solving skills with attention to detail
  • Ability to work independently and within a team
  • Strong negotiation skills
  • Excellent leadership skills
  • Ability to create and maintain excellent working relationships
  • Excellent research and analytical skills
  • Business Analysis skills


Licensure and Certification:
  • Valid driver's license is required; employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if you have started employment in this position, your employment in this position will be terminated


Working Conditions:
  • General office environment; may be required to sit or stand for extended periods of time

Compensation Range:
$83,000.00 - $132,800.00
CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):
Salary

Organization Level Competencies
  • Fostering a Collaborative Workplace Culture
  • Cultivate Partnerships
  • Develop Self and Others
  • Drive Execution
  • Influence Others
  • Pursue Personal Excellence
  • Understand the Business


This job description is not all inclusive. CareSource reserves the right to amend this job description at any time.
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Brand=CareSource

About Caresource

CareSource is a nonprofit health plan that provides managed care services to individuals and families in Ohio, Kentucky, Indiana, and West Virginia. The company was founded in 1989 and is headquartered in Dayton, Ohio. CareSource offers a variety of health insurance plans, including Medicaid, Medicare Advantage, and Marketplace plans. The company is committed to improving the health and well-being of its members and invests in programs and services that promote healthy living. CareSource is one of the largest Medicaid managed care plans in the United States.
Learn more about Caresource
Size
4,000 employees
Industry

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