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Managed Care Contracting Manager

Company: Elderwood Administrative Services
Location: Hamburg
Posted on: June 24, 2022

Job Description:

Join Our Team: Are you looking to take the next step in your career? Overview:
Are you looking to be part of a superior team in a dynamic healthcare organization in Buffalo, NY? If so, this just might be the right opportunity for you! Elderwood has an exciting new opportunity for Managed Care Contracting Manager. This position reports to the Senior Director of Revenue Cycle Management.
Position Overview:

  • The Manager of Managed Care Contracting is responsible for oversight of the third party payer contract process, development of provider relationships, and financial analysis to support the managed care function.Skills/Competencies:
    • Excellent analytical and critical thinking skills
    • Strategic thinking skills
    • Excellent interpersonal and collaborative skills
    • Exceptional ability to articulate, be persuasive, and assertive
    • Outstanding verbal and written communication skills
    • Strong listening skills
    • Ability to evaluate scenarios with limited information, propose sound solutions, and apply problem-solving skills
    • Demonstrated open-mindedness
    • Highly organized
    • Ability to work autonomously
    • Able to prioritize multiple deliverables and meet deadlinesEmployee Perks!: 401K Retirement Plan with Company Match, Close to thruway entrances/exits, Flexible Shifts, Free On-Site Parking, Friendly and supportive staff, Generous PTO & holiday package, Medical, Dental, and Vision insurance, Point-earning employee reward program: redeem for prizes!, Strong leadership, Substantial employee referral program, Tuition reimbursement program Responsibilities:Essential Job Functions
      • Seek opportunities to engage new contracts for skilled nursing and pediatric specialty care facilities.
      • Manage entire contracting process from initially engaging payers to finalizing contract language and rate setting. Participate in negotiation process.
      • Conduct business review of payer contracts and coordinate with legal and other internal stakeholders to manage comprehensive review of new contracts and amendments.
      • Oversee signature and countersignature contract process for skilled nursing and pediatric specialty care facilities. Responsible for organizing and storing fully executed agreements and contract documents for each facility in contract management system and managed care files.
      • Conduct data analysis to produce financial models including profit and loss (P&L) reports and comparison reimbursement scenarios for contract negotiations and budgets.
      • Interface with various departments in developing contractual proposals.
      • Evaluate scenarios, using data analysis, industry knowledge, and information from internal stakeholders. Using this information, present sound recommendations to senior leadership related to contracting and negotiating with third party payors.
      • Collaborate with other key Elderwood Administrative Services staff including, but not limited to revenue cycle and business development, to resolve operational issues and assist with process improvement.
      • Develop and maintain managed care reimbursement tools for facility and organizational use.
      • Create and maintain managed care contract status summaries and tools to keep senior leadership apprised of status.
      • Coordinate and complete external reporting to payers, including credentialing and various required reports and submissions.
      • Develop and foster positive working relationships with key health plan and third-party payor contracting and provider relations contacts.
      • Keep current with changes to federal and state regulations and provider/industry trends as they affect contract structure in providing services.
      • Utilizes electronic timekeeping system as directed.
      • Arrives to work on time, regularly, and works as scheduled.
      • Recognizes and follows the dress code of the facility including wearing name tag at all times.
      • Follows policy and procedure regarding all electronic devices, computers, tablets, etc.
      • Supports and abides by Elderwood's Mission, Vision, and Values.
      • Abides by Elderwood's businesses code of conduct, compliance and HIPAA policies.
      • Performs other duties as assigned by supervisor, management staff or Administrator.
        Skills/Competencies
        • Excellent analytical and critical thinking skills
        • Strategic thinking skills
        • Excellent interpersonal and collaborative skills
        • Exceptional ability to articulate, be persuasive, and assertive
        • Outstanding verbal and written communication skills
        • Strong listening skills
        • Ability to evaluate scenarios with limited information, propose sound solutions, and apply problem-solving skills
        • Demonstrated open-mindedness
        • Highly organized
        • Ability to work autonomously
        • Able to prioritize multiple deliverables and meet deadlinesThis position description is not intended to imply a contract of employment. Employment with Elderwood is "at-will". Employment at-will may be terminated at any time by the employee or Elderwood. All requirements and duties are considered essential functions. Elderwood also reserves the right to adjust workers' schedules and physical locations based on operational needs.Qualifications:Educational Requirements and Qualifications
          • Bachelor's Degree preferred.
          • Minimum five to seven years' experience in provider or health plan setting.
          • Experience in one or more of the following: reimbursement, contract review, or data analysis.
          • Critical thinking and analytical skills required.
          • Must be familiar with industry standard reimbursement methodologies, including Medicare, Medicaid, and other third-party commercial reimbursement as well as federal and state laws as they relate to those payer payment structures.
          • Strong interpersonal and communication skills are necessary to effectively work with providers and payers.
          • Proficiency in Microsoft Word, Excel, Outlook as well as web-based research preferred.EOE Statement: WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Keywords: Elderwood Administrative Services, Buffalo , Managed Care Contracting Manager, Executive , Hamburg, New York

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