Saint Clare’s Health is an award-winning provider of safe, high quality, compassionate care, serving the communities of Morris, Sussex, and Warren counties.
Our multidisciplinary team of experts is committed to providing advanced care in a patient-centered environment that is tailored to meet the needs of each individual and their family.
Saint Clare’s is a member of Prime Healthcare, an award-winning national hospital system headquartered in California, with 46 acute-care hospitals.
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. Ten (10) 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.
We are an Equal Opportunity/Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources. EEO is the Law: https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf