Managed Care Contracting Manager

Minimum three (3) years’ experience required in managed care contracting, negotiations/renegotiations, provider relations, and the healthcare industry. Ability to communicate (both written and orally) with senior management, business office, marketing, case management, and managed care organizations is required.

Overview:

At Ernest Health, we provide specialized medical and rehabilitative services to our patients through our rehabilitation and long-term acute care hospitals. We treat patients who often are recovering from disabilities caused by injuries or illnesses, or from chronic or complex medical conditions.

 

We strive to attract, retain, develop, and empower our employees, supporting them in their professional growth with career advancement opportunities and a path to success within our organization.

 

We are seeking a Managed Care Contracting Manager to join our team of passionate patient caregivers!

 

Qualifications:

At Ernest Health, our patients are family. Healthcare is constantly evolving, our growing organization is devoted to ensuring that each person in our care feels safe. Our world-class team of driven, passionate healthcare professionals are always focused on service excellence and providing top quality care at the bedside.

 

At Ernest Health, employees are our priority. We are passionate about patient care and consider it a privilege to be able to provide services to patients and their family members. Below is a brief summary of our benefits.

• PPO high and low deductible plans / HSA options as well
• FREE prescription plans
• Dental and Vision coverage
• Life insurance
• Short and Long Term Disability
• EAP
• Flex plans, 401K matching
• Company discounts for mobile phone service, electronics, cell phones, clothing, etc
• PET insurance!
• Group legal – provides legal assistance with personal legal matters
• Tuition and continuing education reimbursement
• Work life balance

 

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.