What are the responsibilities and job description for the Manager, Managed Care position at Adventist Health?
Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect.
Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.
Job Summary:
Manages and supports regional managed care contracting and recovery activities. Negotiates health plan (managed care) contracts with payers as assigned across the system. Supervises and directs the activities of various levels of assigned personnel using both professional and supervisory discretion and independent judgment.
Job Requirements:
Education and Work Experience:
- Bachelor’s Degree or equivalent combination of education/related experience: Required
- Master's Degree: Preferred
- Five years' technical experience: Preferred
- One year's leadership experience: Preferred
Essential Functions:
- Reviews and evaluates contract performance models for renewal/ renegotiation. Maintains responsibility for contract implementation, internal and external in-servicing of contract terms.
- Supports executive management in negotiations and revenue recovery activity with payers. Coordinates and facilitates Joint Operations Meetings with payers and affiliated partners.
- Collaborates with management and top professionals/specialists in selection of methods, techniques and analytical approach. Provides day-to-day technical leadership while performing escalated or complex duties. Provides oversight of employees within the work group using advanced technical skills.
- Conducts performance reviews and provides input on direct reports for human resource decisions such as hiring, promotions and disciplinary actions. Participates in the development of employees.
- Maintains responsibility for adherence to budget for specific projects. Participates in the preparation of the department budget.
- Performs other job-related duties as assigned.
Organizational Requirements:
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.
