Business Professional Job In Palm Springs, Florida
Manager, Managed Care ContractingNext Steps... Apply Now
General Statement of Job
This position manages all managed care payer contracts for all District sites including drafting, negotiating, maintaining, and auditing.
Specific Duties and Responsibilities
Negotiates managed care payer agreements and ensures financial and business requirements are addressed through negotiations.
Maintains active database of managed care contract, insures timely renewal and communicates essential terms to applicable departments.
Manages processes required to insure managed care contracts are implemented in an accurate and timely manner.
Ensures that administrative requirements contained in managed care contracts are adhered to and that the contractual relationship is performing as expected.
Interacts with various stakeholder department heads and staff to identify issues, help facilitate the resolution of those issues and educate staff related to managed care contracts.
Participates in efforts to identify and resolve internal process issues that result in denials of managed care claims.
Develops internal reports to communicate contract status, opportunities, and issues in managed care and accounts receivable.
Conducts initial review of contract language on all managed care contracts for the purpose of identifying, evaluating and implementing opportunities to enhance the Districts participation within managed care networks.
Stays informed about changes within the managed care industry and communicates said changes to appropriate management within the organization.Customer Service:
Knows and recognizes his/her customers and focuses on delivering to them the highest quality services(s) in the context of the overall mission.
Expresses ideas effectively face-to-face, as well as in writing, in individual and group situations, adjusting language and terminology to the needs of the audience, and the ability to synthesize information received verbally and in writing.
Creates effective working relationships within and across organizational boundaries.
Initiative and Ingenuity:
Maintains the capacity for self-motivation that is manifested by innovation and creativity.
Commitment to Quality:
Consistently maintains a high level of quality that meets specific standard operating practices and procedures, consistent with organizational goals.
Makes use of work time in an efficient and productive manner.
Promoting Quality, Customer Service and Productivity:
Utilizes continuous quality assurance processes to ensure quality, appropriate services are rendered to the customer in order to meet or surpass established goals and objectives
Meeting Strategic Goals and Objectives:
Plans actions to accomplish designated and desired outcomes.
In the interest of ensuring continued workforce diversity at the Health Care District every staff member is required to:
• Promote team building among a diverse workforce, model a positive attitude regarding diversity, create and maintain a work environment that is respectful and accepting of diversity, and demonstrate recognition of the value of individual and cultural differences.
• Ensure that service delivery is provided in a culturally competent way and consistently treat customers, partners, and coworkers with dignity and respect.
This job description reflects the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered as a complete description of all the work requirements and expectations that may be inherent in the position. The omission of specific statements of duties does not exclude them from the position. Management of the Health Care District of Palm Beach County reserves the right to assign duties not listed herein as necessary to accomplish the goals of the organization.
Bachelor's degree in business administration, accounting, finance or closely related field required.
Three to four years of experience in managing payer contracts in an integrated healthcare environment. Knowledge of hospital and physician practice regulatory environment required. Proven ability to interact with physicians and other executives in a tactful and professional manner. Experience in computer spreadsheets required.
Valid State of Florida Driver’s License with Safe Driver designation required.
The Health Care District is an Equal Employment Opportunity Employer and maintains a Drug Free Workplace. Veterans preferred. Qualified individuals with disabilities who require an accommodation to participate in the application process or candidates with other questions should contact Human Resources.
Dedicated to the Health of the Community The Health Care District of Palm Beach County is an integrated public health system established in 1988 as a special taxing district that is an equal opportunity employer of approximately 1,000 employees. The Health Care District's mission is to ensure access to a comprehensive health care system and the delivery of quality services for the residents of Palm Beach County. The Health Care District provides challenging and fulfilling employment opportunities through its health coverage programs for uninsured residents, a nationally recognized Trauma System, adult and pediatric services at the four C. L. Brumback Primary Care Clinics, a School Health program which staffs registered nurses in nearly 170 public schools, a pharmacy operation, a long-term skilled nursing and rehabilitation center, and its acute care hospital, Lakeside Medical Center, in rural western Palm Beach County.