Dir-Managed Care Contracts

Ascension Health Amsterdam , NY 12010

Posted 2 months ago

We Are Hiring

Dir-Managed Care Contracts

  • Managed Care Contracting 001 - Full-Time, Day

  • St Mary's Hospital

  • Amsterdam, NY

8am-5pm Monday-Friday

Why Join Ascension?

St. Mary's Healthcare, based in Amsterdam, New York, provides a full range of outpatient services while featuring an award-winning acute care hospital, three Urgent Care Centers, multiple primary and pediatric health centers, specialty care including Cancer Medicine, Gastroenterology, OB-GYN, ENT, Surgical and Urology, inpatient and outpatient mental health services and a 160-bed nursing home. The organization has earned outstanding national rankings for excellence in medicine and patient safety.

St. Mary's Healthcare is part of Ascension, a faith-based healthcare organization dedicated to transformation through innovation across the continuum of care. As one of the leading non-profit and Catholic health systems in the U.S., Ascension is committed to delivering compassionate, personalized care to all, especially to those most in need. In FY2018, Ascension provided nearly $2 billion in care of persons living in poverty and other community benefit programs.

What You Will Do

As an Associate with St. Mary's Hospital

  • NY, you will have the opportunity to monitor and reports financial performance of managed care contracts.

Responsibilities:

  • Oversees utilization and financial reports used for contract payment, performance and improvements. Develops and tests pricing models with contracted payers that maximize net operating margins and ensure market competitiveness.

  • Oversees all updates, changes, compliance and regulatory functions as they relate to managed care contracts.

  • Serves as network contact for managed care contracting functions. Provides resolution to managed care contractual issues pertaining to contract interpretation and coding with payers.

  • Assesses managed care contracting requirements and standards as they relate to industry/regulatory issues and market implications. Recommends and implements necessary improvements and revisions to contracting requirements and standards.

  • Evaluates and recommends financial parameters and reimbursement methodologies.

What You Will Need

Education:

  • High school diploma/GED with 2 years of experience, or Associate's degree, or Bachelor's degree required Master's degree preferred

Work Experience:

  • 5 years of experience required. 10 years of experience preferred. 2 years of leadership or management experience required. 5 years of leadership or management experience preferred.

  • Experience in payer contracting either with health care provider or insurance company

Equal Employment Opportunity

St. Mary's Hospital is an equal opportunity employer and affords equal opportunity to all applicants for all positions without regard to race, color, religion, gender, national origin, age, disability, veteran status, sexual orientation or any other status protected under local, state or federal laws.

State and Federal laws prohibit discrimination on the basis of race, creed, color, religion, gender, national origin, age, disability, marital status or sexual orientation.

Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.

E-Verify Statement

St. Mary's Healthcare participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information.

E-Verify


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Dir-Managed Care Contracts

Ascension Health