Director, Managed Care
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Job Description
Director of Managed Care overseeing strategic partnerships with Managed Care Organizations and revenue development through clinical integration. Collaborating with cross-functional teams for operational success.
Responsibilities:
- The Director, Managed Care is responsible for strategic partnerships with Managed Care Organizations, Post-Acute providers, and Health systems.
- Assists with business operations, audit/compliance, and analytical support.
- Advises senior management of business opportunities and strategies.
- Leads and advances Strategic Partnerships for the Company, including clinical integration, enhancements in reimbursement, and innovative development.
- Provides guidance and direction to cross-functional business team members including Operations, Sales, Billing and/or Finance.
- Ensures timely and accurate setup and ongoing maintenance of contracts with contracted entities.
- Manages a portfolio of clients to identify and deliver on business opportunities and projects.
Requirements:
- Bachelor’s degree in relevant discipline from an accredited college required.
- Seven (7) years of relevant work experience required in contracting, credentialing, or network management.
- Five (5) years of management experience in related position is preferred.
- Proven leadership skills
- Ability to handle complex contract negotiations.
- Proficient knowledge of medical contracting methodologies and claims pricing/reimbursement strategies
- Independent thinker and decision maker
- Strong analytical and problem-solving skills with attention to detail
- Excellent verbal and written communication
- Strategic business partner
- Proficient computer skills and knowledge of Microsoft Office specifically Excel
- Ability to prioritize and manage multiple projects.
- Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction.
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