Manager of Healthcare Contracting

Location: Aurora, IL
Date Posted: 12-31-2018
CareNational
Manager of Contracting – Managed Care
Aurora, IL (western suburb of Chicago)
  

Manager of Contracting Job Summary:
 
  • Manages and monitors managed care vendor and provider relationships and services in conjunction with the Regional Directors, managing the Managed Care Specialists, and participating in plan design and analysis projects
  • Collaborates with senior leadership to develop and implement plans for the operational infrastructure of systems, processes, and personnel that support strategic goals and initiatives
  • Creates, motivates and leads a high performing team; provides mentoring as a foundation of career development and builds a culture designed to engage, enable and empower staff
  • Directs functions, staff and systems necessary to ensure that health plan participants and their families receive benefit coverage timely and without unnecessary delay
  • Establishes and maintains appropriate procedures and controls to ensure accuracy, efficiency, productivity and regulatory compliance is maintained for areas of accountability
  • Maintains and cultivates strong relationships with multiple internal and external stakeholders across geographic regions
  • Creates and directs an efficient and effective operating system to enable all Fund customers to receive the highest level of service by getting accurate, consistent and timely answers specific to their inquiries, using problem-solving and results-based parameters
  • Plans and prepares operating budget
 
Manager of Contracting Background:
 
  • Requires Bachelor's degree in Business Administration, Public Health, Healthcare Administration or related field or equivalent work experience: Master’s degree a plus
  • At least 7-10 years of related experience , including 3-5 years of team management experience
  • Working knowledge and experience with current legislative requirements under ACA, COBRA, HIPAA, DOL, etc. as they relate to health benefits eligibility, payment, and appeals
  • Demonstrated leadership and interpersonal skills in order to lead others to achieve results in a team oriented environment through the use of feedback, accountability and change management
  • 3-5 years Provider and/or Vendor contracting experience including negotiating contract provision and financial reimbursement/payment rates.
  • Working knowledge of multiple health services reimbursement methodologies including, capitation, per diems, DRG’s and RBRVS fee schedules.
  • Experience in process improvement, creating efficiencies, documenting processes including development of policy and procedure manuals
  • 3-5 years Project Management experience including leading and participating in cross functional teams to deliver on expected outcomes.

 
#ADMIN
 
 
PRASHANT PATEL
STRATEGIC DIRECTOR
CareNational
prashant@carenational.com
480.646.3275 (CALL – TEXT – FAX)
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