What are the responsibilities and job description for the Manager, Managed Care position at Saint Francis Hospital, Inc.?
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Full TimeDays
Location : Tulsa, OK
Schedule : Monday - Friday | 8 : 00am - 5 : 00pm
Job Summary : The Manager, Managed Care oversees the modeling, rate development and negotiation of facility, ancillary and professional payor contracts for Saint Francis Health System (SFHS). Partnering with internal business partners, this role manages the rate and contract negotiations, and the full contracting process including but not limited to the execution, implementation, and performance of all managed care agreements.
Minimum Education : Bachelor’s degree in Business Administration or related field.
Licensure, Registration and / or Certification : None.
Work Experience : Minimum 3 years of related experience with contract negotiations including 1 year in a leadership role.
Knowledge, Skills, and Abilities : Knowledge of Microsoft 365 and other applicable software. Excellent communication skills, both written and verbal that present clear and concise information. Proven ability to perform financial analysis and negotiations. Ability to work independently and collaboratively in a fast-paced environment, managing multiple priorities with competing deadlines.
Essential Functions and Responsibilities : Oversees managed care contract negotiations with payors for improved rates and terms related to participation on behalf of the health system. Coordinates the implementation and manages the performance of managed care agreements by interfacing with internal departments. Evaluates specific health system programs and pricing for their impact on managed care contracts and the overall health system revenue stream. Negotiates single-case rates service lines and manages various processes such as the No Surprises Act (NSA) and the Independent Dispute Resolution (IDR) to ensure compliance is maintained. Coordinates operational workflows with internal business partners and departments reliant on Managed Care interface and responsiveness. Supervises team members in preparation of monthly reports presented to senior management detailing financial performance of fee for service and risk managed care contracts for the health system.
Decision Making : The carrying out of non-routine procedures under constantly changing conditions, in conformance with general instructions from supervisor.
Working Relationships : Direct Supervision of others. Prepares and gives performance evaluations. Works directly with patients and / or customers. Works with internal and / or external customers via telephone or face to face interaction. Works with other healthcare professionals and staff. Works frequently with individuals at Director level or above.
Special Job Dimensions : None.
Supplemental Information : This document generally describes the essential functions of the job and the physical demands required to perform the job. This compilation of essential functions and physical demands is not all inclusive nor does it prohibit the assignment of additional duties.
Managed Care - Yale Campus
Location :
Tulsa, Oklahoma 74136
EOE Protected Veterans / Disability
