What are the responsibilities and job description for the Manager - Managed Care Financial Operations position at ACCESS Community Health Network?
Position Summary
The Manager, Managed Care Financial Operations manages the daily operations of the Managed Care Department, including a team and processes to design, analyze, negotiate, implement, and monitor managed care contracts.
Core Job Responsibilities
• Manage day to day interactions with health plans. Collaborate with other departments to understand and communicate issues to health plans
• Responsible for the review and monitoring of managed care contracts including compliance to contract terms, requirements from provider manuals and any other related contractual documents; performs audits based on contractual agreement and establishes corrective action plans as necessary.
• Ensures managed care contracts are in support of ACCESS care model and associated standard access to care, care coordination, case management, quality metrics
• Responsible for reviewing managed care contract information and creating materials to help disseminate new and/or updated information to a variety of ACCESS audiences.
• Provide data analysis and performance reporting in support of managed care contracts and program efforts, including financial modeling
• Manages day to day claims processing operations
• Manage direct reports, communicating expectations, providing coaching and feedback, monitoring and managing performance and providing development opportunities
• Perform other duties as assigned
Requirements/Preferences
• Bachelor’s degree required, health or business field preferred
• Minimum of 3 years’ experience in a healthcare provider or managed care operations required
• Minimum 2 years’ experience managing staff required
• Intermediate proficiency in Microsoft Office required, especially in Word, Excel, and PowerPoint
• Experience negotiating contracts and terms preferred
• Experience in financial modeling preferred
Salary : $78,100 - $91,900
