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Contracts Manager (Managed Care) in Los Angeles, California at TeamHealth

Date Posted: 5/6/2019

Job Snapshot

Job Description

 

JOB DESCRIPTION OVERVIEW:

This position offers Remote work possibility.

The Contract Manager has the responsibility for assisting the Vice President to manage and negotiate assigned Managed Care Plans including analysis of the proposed contracts, conducting financial impact studies and proposing negotiating tactics. This position interacts with various individuals, which include corporate and group operational management, client hospitals, and physician leadership.

This position supports the West Region, and includes EM and HM services and related lines of business.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Assists the Vice President to manage all aspects of the negotiation of managed care plans including, but not limited to, examination and analysis of contract documents, evaluation of the financial implications of the proposed contract, and developing negotiating tactics and strategy.
  • Oversees notification of TeamHealth on all managed care billing arrangements.
  • Monitors and develop existing systems to increase effectiveness and efficiency.
  • Utilizes information systems, such as IDX and Excel, to develop financial analysis of managed care plans.
  • Reviews and development of managed care reports.
  • Supports and promotes effective communication and interaction with representatives from the billing operation centers, affiliates, and managed care organizations.
  • Acts as a liaison with hospitals in resolving managed care issues.
  • Responsible for maintaining information regarding managed care contracts.
  • Reviews each proposed managed care agreement and make recommendations for changes and modifications to conform to TeamHealth contract guidelines.
  • Reviews requests submitted for the creation of new financial classes (FSCs).
  • Accountable to manage the contract files for all managed care plans including updates on pending expirations or proposed amendments, and file maintenance.
  • Coordinates and ensures proper loading of contract terms into IDX and ongoing maintenance.
  • Manages and completes projects as assigned by the Vice President.
  • Assists with the following: claims issues; new start-ups and integrations; budgeting; litigations requests/needs, entity changes impacting contracting.
  • Effectively communicates with internal associates and leadership.

Job Requirements

QUALIFICATIONS / EXPERIENCE:

  • Experience with multi-State managed care contracting for Emergency Medicine and Hospital Medicine (inpatient, SNF, behavioral health) professional services.
  • A bachelor’s degree in business or healthcare administration is preferred or equivalent education and experience.
  • A minimum of 3 to 5 years of experience in managed care contracting with a payer, hospital or large physician practice.
  • The ability to interact with staff in a professional, supportive, and effective manner.
  • An understanding of proper negotiation techniques.
  • Demonstrate the capacity to utilize software applications and databases including IDX BAR and TeamWorks.
  • An understanding and application of medical billing and reimbursement procedures/practices.
  • The ability to comprehend and think logically, as well as proven leadership skills.
  • Strong oral and written communication skills.
  • The ability to interrelate, teach and convey information to the staff.
  • Must have a good working knowledge of Microsoft Office software such as MS Excel, MS Word, and MS PowerPoint and ability to manage / use databases.

SUPERVISORY RESPONSIBILITIES:

  •  None

PHYSICAL / ENVIRONMENTAL DEMANDS:

  • Job performed in a well-lit, office setting
  • Occasional lifting (15 pounds or less)
  • Occasional standing/bending/reaching/stooping
  • Occasional travel
  • Moderate stress
  • Prolonged sitting
  • Prolonged work on a PC/computer.

This position may require manual dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, fax) and/or the ability to perform repetitive motions and/or meet production standards to comply with the essential functions. Also, may require physical and/or mental stamina to work overtime, additional hours beyond a regular schedule and/or more than five days per week.

Join a team of dynamic, results oriented professionals!

Named among “The World’s Most Admired Companies" by Fortune Magazine
Named among "America's 100 Most Trustworthy Companies" by Forbes magazine
Named among “Great Places to Work" by Becker’s Hospital Review

  • Benefit Eligibility (Medical/Dental/Vision/Life) the first of the month following 30 days of employment
  • 401K program (Discretionary matching funds available)
  • Employee Assistance Program
  • Dental plans & Vision plans
  • Eight Paid Holidays per year
  • Business casual dress code
  • Wellness programs

DISCLAIMER:

The information contained in this job description has been designated to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this position.