Managed Care Contracting Administrator

Job Description

Develops managed care contract proposals for health system entities. Addresses operational issues and ensures contract rates and contract terms are implemented with the ultimate goal of maximizing system revenue.

Job Responsibility

• Develops and analyzes the impact of managed care contract proposals on the organization.

• Works with management to interpret contract language as it relates to managed care reimbursement rates and contractual provisions.

• Assists senior staff in document preparation of proposals, contracts and settlements.

• Collaborates with internal organization departments and outside vendors to facilitate contract implementation.

• Participates in development of various ad hoc contractual reports and other educational material for internal customers.

• Works collaboratively with physician groups, and Faculty Practice business office to implement and monitor contract performance.

• Works collaboratively with organization ancillary and post-acute providers to monitor contract performance and assist with contractual issues.

• Interfaces with insurance companies/third party payers on a routine basis to communicate organization issues and to resolve operational or systemic payment issues.

• Operates under general guidance and work assignments are varied and require interpretation and independent decisions on course of action.

• Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.

Job Qualification

• Bachelor's Degree required, or equivalent combination of education and related experience.

• 1-3 years of relevant experience, required.

• Additional Salary Detail

The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).