Finance and Accounting Job In Irving, Texas
Manager Managed Care - Financial Services
Irving, Texas 75039 Type of Facility: Hospital
Summary:
This position is responsible for managing daily activities as assigned by System Director or Director related to providing operational support on managed care contracts. The candidate will be responsible for working directly with managed care payers and PFS to resolve claim payment and administrative escalations occurring with managed care contracts. Responsible for the mentoring and training of team members as needed, providing subject matter expertise to improve efficiencies and results. The candidate will work collaboratively with Vice President Managed Care, Managed Care Team, Revenue Integrity, and PFS management.
Responsibilities:
- Assists the point person" to the hospital leadership teams and business offices for the assigned CHRISTUS region(s) for all managed care related aspects, including contract performance and operational issues Carries out appropriate managed care related education and training including roll out of new payor contracts
- Assists in payor/plan dispute resolution projects or any other special projects
- Responsible for coordinating payer credentialing & re-credentialing activities
- Works with the hospital business offices with regard to tracking and reducing managed care denials and underpayments, including restitution or other prompt pay penalties
- Knowledge of Federal and Texas general regulatory environment related to managed care and participates in legislative advocacy activities as appropriate
- Monitor implementation managed care contracts for all CHRISTUS Health Providers
- Develop payer performance and monitoring tools
- Conduct data analyses/reports to the assigned System Director or Director on payments and operational issues associated with Managed Care contract language
Requirements:
- Bachelor's Degree preferred
Work Type:
Full Time
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CHRISTUS Health is an international Catholic, faith-based, not-for-profit health system comprised of more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures.
Sponsored by the Sisters of Charity of the Incarnate Word in Houston and San Antonio and the Sisters of the Holy Family of Nazareth, the mission of CHRISTUS Health is to extend the healing ministry of Jesus Christ.
To support our healthcare ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on staff who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.
EXTENDING THE HEALING MINISTRY OF JESUS CHRIST
We are inspired by our mission, vision and core values to deliver compassionate, high quality health care, improving the health of the communities we serve. Above all, we are committed to providing our customers and their family members with a truly unique healing experience, one that embodies our values and respects the dignity and worth of each person. Creating a health care system that is truly excellent in all areas is an ongoing effort.