Manager of Managed Care Contracting assists the VP of Managed Care Contracting through the development and enhancement of relationships with health plans and other Payors to secure optimal reimbursement and protect the interests of Prime Healthcare through the implementation, interpretation and administration of managed care contracts for the NJ/PA region. Monitors quality and healthcare cost performance improvement activity as it relates to contract reimbursement. Monitors market for legal and regulatory developments in Healthcare as it relates to changes in the Payor landscape. Represents the organization in a positive, professional manner in the community and among other Managed Care and related professional organizations.
EDUCATION, EXPERIENCE, TRAINING
1. Experience with Reimbursement/Claims Settlements required.
2. Four (4) years of managed care experience, including contracting, provider and payer relations, account management, business development and growth-related functions.
3. Degree in Finance, Business or Healthcare Administration preferred.
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