Overview
The Managed Care Operations Lead serves as a resource and advisor, directs all aspects of managed care operations including system wide credentialing with managed care plans, contract performance monitoring and reporting, and contract payment modeling and analysis. Works in collaboration with Chief Financial Officer, consultants Vice President of Finance, Director and Managed Care Specialists to recommend contracting strategies, perform complex contract modeling, and to monitor health plan performance. Acts as a liaison between Managed Care Contracting, Reimbursement, Patient Financial Services, Patient Access and other departments in the hospital in an effort to create seamless operational performance and reimbursement maximization related to managed care contracting and performance monitoring.
Department Description
Licensure
Not Applicable
Education
Bachelor's Degree Business Administration Or Healthcare Or Finance Or Related Field Required - And Master's Degree Health Administration Or Business Preferred
Experience
10 Years Managed Care Contracting Required - With 7 Years Managed Care Contracting In Healthcare Required
