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Manager of Managed Care and Contracting

NewVista Healthcare
Blue, OH Full Time
POSTED ON 1/16/2025
AVAILABLE BEFORE 4/15/2025

Manager of Managed Care and Contracting - New Vista and Lynx

The  CommuniCare Family of Companies  is a fast-growing provider of long-term care with facilities located throughout 6 states. Our health care centers include over 100 skilled nursing facilities, 5 behavioral health hospitals, 3 substance abuse treatment centers, outpatient behavioral health services, and a transportation company. All our centers are dedicated to the CommuniCare goal of creating  Caring Communities  where staff, residents, patients, and families join hands to overcome their daily challenges.

CommuniCare is currently looking to fill a key position,  Manager of Managed Care and Contracting,  for  New Vista , our Behavioral Health division, and  Lynx , our transportation operations.

PURPOSE / BELIEF STATEMENT

The Manager of Managed Care and Contracting is responsible for securing managed care contracts for New Vista and Lynx. The Manager is responsible for full-managed care contract life-cycle support, including negotiations of new business and revenue development through continued clinical integration and market expansion. This position reports to the Corporate Director of Contracting & Managed Care.

WHAT WE OFFER

CommuniCare employees enjoy competitive market salaries, PTO plans, and a robust benefits package for full time employees. Our ‘perks at work’ include healthcare plans, life / family balance, education and leadership opportunities, and employee recognition and rewards.

QUALIFICATIONS / KNOWLEDGE / SKILLS / EXPERIENCE REQUIREMENTS

To qualify for the Manager of Managed Care and Contracting role, you must have :

  • Experience with behavioral health hospitals, substance abuse treatment centers, and medical transportation contracting.
  • Knowledge and relevant work experience in the Managed Care / insurance sectors including network planning / development, contract negotiations, etc.
  • Presentation experience, excellent written and verbal communication skills
  • Proficient knowledge of medical-contracting methodologies, claims pricing, and reimbursement strategies.
  • Independent thinking and decision-making skills.
  • Strong analytical and problem-solving skills with attention to detail.
  • Proficient computer skills and knowledge of Microsoft Office, specifically Excel.
  • Ability to prioritize and manage multiple projects.
  • Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction.

JOB RESPONSIBILITIES

As Manager of Managed Care and Contracting, you will :

  • Develop and implement strategic plan regarding payors.
  • Renegotiate reimbursement on an annual basis.
  • Oversee and leverage existing payor relationships.
  • Identify the objectives necessary for our company to succeed as a health care system.
  • Provide support and education related to managed care
  • Train and educate on Managed Care and serve as a subject matter expert on contract and reimbursement-related issues impacting our industry.
  • Position may also be assigned to direct supervise certain employee / s.
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