5 Contract Manager - FT - Days - Managed Care Contracting @ MV Jobs in Mountain View, CA
El Camino Health is Hiring a Contract Manager - FT - Days - Managed Care Contracting @ MV Near Mountain View, CA
Scheduled Bi-Weekly Hours80
Work ShiftDay: 8 hours
Job DescriptionJob Responsibilities:
- Negotiates and manages specialty services agreements (i.e. behavioral health agreements, cash pay agreements, medical group agreements), including analyzing financial data, including costs, volumes, types of services and current expected reimbursement and the financial impact of these specialty service agreements.
- Works with internal departments and service line leaders on any issues related to specialty service agreements
- Single Case Agreements - research data necessary for various single case agreements; prepare document for signature; update all involved parties.
- Manage Center of Excellence applications/renewal process- track data requirement submission by various departments in hospital; ensure timely submission of data.
- Manage insurance code assignment process for new codes and/or codes to delete.
- Effectively track and monitor outstanding issues and communicate proactively with stakeholders.
- Maintain contract grid of terms and conditions from the various health plan contracts to serve as job aids for Revenue Cycle team.
- Participate in quarterly/monthly joint operations committee meetings with the health plans.
- As applicable, review of Health plan provider manual and policy updates, review new health plan policies for applicability; distribute to impacted departments for input; track responses; submit policy disputes within required 45 day response time.
- Bachelor's Degree required.
- Minimum six (6) years experience in the managed care field representing hospitals, physicians or payers in contracting functions.
- Ability to review and understand managed care contracts
- Highly collaborative and able to work cohesively in a dynamic team environment.
- Good communicator, skilled in negotiations, able to develop and sustain relationships with health plans
Salary Range$61.80 - $92.70 USD Hourly
The Physical Requirements and Working Conditions of this job are available. El Camino Health will provide reasonable accommodations to qualified individuals with a disability if that will allow them to perform the essential functions of a job unless doing so creates an undue hardship for the hospital, or causes a direct threat to these individuals or others in the workplace which cannot be eliminated by reasonable accommodation.Sedentary Work - Duties performed mostly while sitting; walking and standing at times. Occasionally lift or carry up to 10 lbs. Uses hands and fingers. - (Physical Requirements-United States of America)
An Equal Opportunity EmployerEl Camino Health seeks and values a diverse workforce. The organization is an equal opportunity employer and makes employment decisions on the basis of qualifications and competencies. El Camino Health prohibits discrimination in employment based on race, ancestry, national origin, color, sex, sexual orientation, gender identity, religion, disability, marital status, age, medical condition or any other status protected by law. In addition to state and federal law, El Camino Health also follows all applicable fair and equitable employment policies from the County of Santa Clara.
Job Summary
Full Time
Ancillary Healthcare
$87k-115k (estimate)
06/10/2024
07/04/2024
elcaminohealth.org
SAN JOSE, CA
25 - 50
1961
$10M - $50M
Ancillary Healthcare
Related Companies
About El Camino Health
**NOTE: Please check elcaminohealth.org/jobs for official job postings and exercise caution if you receive an unsolicited job offer from an individual not using an official elcaminohealth.org email address or phone number.** El Camino Health provides a personalized healthcare experience at two non-profit acute care hospitals in Los Gatos and Mountain View as well as primary care, multi-specialty care and urgent care locations throughout Santa Clara County. Bringing the best together in new technology and advanced medicine, our network of nationally recognized physicians and care teams deliver ...high-quality, compassionate care to the communities it serves. Key medical specialties include heart and vascular, cancer, lifestyle medicine, mental health and addiction services, pulmonary, maternal child heath, orthopedic and spine, neurology and stroke as well as urology. El Camino Health hospitals and its caregivers have earned numerous awards for excellent clinical quality, including a 5-Star Overall Hospital Quality Rating from Centers for Medicare & Medicaid Services (CMS) and four consecutive American Nurses Credentialing Center Magnet Recognitions for Nursing Care.
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