Manager, Hospital Contracting & Reimbursement Systems

Hcsc Chicago , IL 60602

Posted 3 weeks ago

Job ID: HF-1034450

Description:

At HCSC, building a talent engine for the future is a key priority because we recognize that as our business evolves to reflect the changing world, we must adapt our workforce to meet this challenge. Additionally, with "excellence" as one of our core values, we are focused on improving our success measures and delivering the best possible customer experience.

BASIC FUNCTION:

The Manager of Hospital Contracting & Reimbursement Systems is responsible for managing and coordinating provider recruitment, credentialing, education and servicing activities. She or he will work on negotiating agreements, monitoring reimbursement arrangements, and analyzing the networks regularly for provider accessibility and availability.

The Manager will also evaluate network adequacy requirements according to CMS, reporting deficiencies, and work with Sales/Marketing in accessing the competitive position of the networks as related to the market. In addition, responsibilities will include performing major new contracting activities for public managed care programs including Illinois Medicare Advantage HMO and PPO, Medicaid, as well as other Public Network Programs.

JOB REQUIREMENTS:

  • Bachelor Degree and 3 years health care administration or managed care experience.

  • 2 years network management experience for public managed care programs (for example: Medicare Advantage, Medicaid, VA).

  • 3 years management experience.

  • Experience and knowledge of CMS requirements and regulations.

  • Financial acumen in health care administration.

  • Analytical and planning skills.

  • Negotiation and contracting skills.

  • Clear and concise verbal and written communication skills including presentation skills.

  • Experience with interacting with all levels of corporate personnel and providers.

  • Relationship building acumen to develop relationships with providers.

  • Leadership skills.

  • Ability to travel, including overnight stays

PREFERRED JOB REQUIREMENTS:

  • Knowledge of network contracting including contract performance, interpretation and application of findings to contracts, and contract structure and financial impact on each line item.

  • Project management skills, including strong organization, prioritization and problem solving skills; strong oral, verbal and interpersonal communication skills; ability to accept direction and feedback

  • Knowledge of financial reporting.

This position is based in Chicago, IL.

Relocation will not be provided for this position.

Sponsorship will not be provided for this position.

  • CA

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

Requirements:

Expertise Network Management / Provider Relations Job Type Full-Time Regular Location IL - Chicago


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Manager, Hospital Contracting & Reimbursement Systems

Hcsc