Manager Managed Care Payer Relations

UNC Health

  • Morrisville, NC
  • 10 days ago

    Highlights

    This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job. Responsibilities: Payer Relations- Manages relationships and represents UNC HCS as a primary point of contact and liaison in various managed care contractual relationships, handling communication, contract compliance, problem resolution, legal issues, etc.

    Numbers & Facts

    LocationMorrisville, NC

    Description

    Job Description

    Description

    Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina.

    Summary:

    The Managed Care Payer Relations Manager manages the day- to- day activities of the payer relations function. Develops, manages, and sustains relationship with managed care payers. Serves as a resource, answering questions and providing information about network procedures or contracts. Reviews billings and claims payments according to managed care contracts.

    Responsibilities:

    1. Payer Relations- Manages relationships and represents UNC HCS as a primary point of contact and liaison in various managed care contractual relationships, handling communication, contract compliance, problem resolution, legal issues, etc.

    2. Managed Care Analysis- Identifies management information needs; researches and analyzes data to provide necessary information to leadership positions. Analyzes financial, contractual, and operational issues related to contracted payers. Reports to Health Care System leadership the financial impact of billing and claims payment issues according to managed care contracts. Verifies the accurate and on-time loading of professional fee schedules by payers and in the UNC HCS Contract Manager tool.

    3. Leading People- Leads people toward meeting the organizations vision, mission, and goals. Provides an inclusive workplace that fosters the development of others, facilitates cooperation and teamwork, and supports constructive resolution of conflicts. Treats sensitive or confidential information appropriately. Works to improve and reinforce performance of others. Delegates assignments, clarifies expectations and holds others accountable for achieving results related to their area of responsibility. Encourages workforce engagement by building a commitment to excellence. Works collaboratively toward solutions that accomplish organizational objectives.

    Other Information

    Other information:

    Education Requirements:

    Bachelor's degree in relevant field

    Licensure/Certification Requirements:

    Professional Experience Requirements:

    Requires five (5) years of experience with managed care contracts and provider relations. If Associate's degree, requires nine (9) years of experience with managed care contracts and provider relations.

    Knowledge/Skills/and Abilities Requirements:

    Job Details

    Legal Employer: NC Health

    Entity: Shared Services

    Organization Unit: Managed Care

    Work Type: Full Time

    Standard Hours Per Week: 40.00

    Salary Range: Pay offers are determined by experience and internal equity

    Work Assignment Type: Hybrid

    Work Schedule: Day Job

    Location of Job: US:NC:Morrisville

    Exempt From Overtime: Exempt: Yes

    This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job.

    Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.

    UNC Health makes reasonable accommodations for applicants and employees religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email [email protected] if you need a reasonable accommodation to search and/or to apply for a career opportunity.

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