Managed Care Contracting Manager - Ernest Health

At Ernest Health, we provide specialized medical and rehabilitative services to our patients through our rehabilitation and long-term acute care hospitals. We treat patients who often are recovering from disabilities caused by injuries or illnesses, or from chronic or complex medical conditions.

We strive to attract, retain, develop, and empower our employees, supporting them in their professional growth with career advancement opportunities and a path to success within our organization.

We are seeking a Managed Care Contracting Manager to join our team!

As a participating hospital of Ernest Health, we offer robust recognition, wellness, and retention programs.  These programs focus to enhance the employees’ work experience, recognize, and celebrate achievements.  We also encourage employees to share their work experience through “My Ernest Journey” and through our Engagement Survey, where our approach is “You Spoke, We Listened”.  These platforms provide additional avenues for employees to give feedback about their work experience and share what is important to them.

Our hospital offers comprehensive benefits, designed to support your health and financial well-being.

Benefits:

• PPO and High Deductible Medical Plan options
• Flexible Spending and Health Savings Account options available
• Dental and Vision coverage
• 401K with employer matching
• Life insurance
• Short-and-long term disability

Wellness & Work Life Balance:

• Employee Assistance Program
• Wellness Program with quarterly wellness challenges with participation incentives
• Earned Time Off - start accruing vacation time on start date

Required Skills:

• Minimum three (3) years’ experience required in managed care contracting, negotiations/renegotiations, provider relations and the healthcare industry.
• Bachelor’s Degree preferred OR any equivalent combination of education and experience.
• Strong analytical and negotiating skills.
• Knowledge of managed care procedures and laws required.
• Knowledge of Federal and State healthcare regulations pertaining to Medicare, Medicaid required.
• Ability to communicate (both written and orally) with senior management, business office, marketing, case management, and managed care organizations is required.

Additional Qualifications/Skills:

• Strong interpersonal skills and partnership skills to include negotiation.
• High degree of accuracy and attention to detail.
• Discretion in dealing with sensitive confidential information.
• Demonstrates honesty and integrity at all times.
• Ability to carry out duties with limited supervision.
• Knowledge of regulatory standards and compliance requirements.
• Demonstrates general computer skills including: data entry, word processing, email, and record management.
• Ability to meet deadlines.
• Ability to prioritize and multi-task.
• Effective organizational and time management skills.
• Effective written and verbal communication skills.
• Ability to maintain quality and safety standards.
• Ability to project a professional image.
• Ability to work closely and professionally with others.

The Managed Care Contracting Manager is responsible for system-wide managed care contracting including negotiation/re-negotiation of language and reimbursement terms. Serves as the liaison between Managed Care Organizations and Company. Provides support and communicates contract terms and reimbursement methodologies to hospitals and clinics in order to maximize managed care contracts performance. Assists hospitals and support staff with payor issues and discrepancies related to contract terms to create a seamless operational performance. If needed, perform credentialing and re-credentialing according to plan specifications in a timely, accurate fashion. Track all performance for reporting purposes.