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Director of Managed Care Contracting

 

Director of Managed Care Contracting

Centers Health Care is actively seeking an experienced Managed Care Director.

 

Qualifications:

  • Eight or more years' experience in hospital/health care contracting related activities required.
  • Must have at least three years of experience supervising staff in payer contracting activities in a leadership role.
  • Healthcare contracting in Managed Care, Medicare, and Medicaid required.

 

Duties and Job Responsibilities: 

  • Responsible for leading and directing Managed Care activities on behalf of all Centers Health Care affiliated business entities.
  • This entails a market and financial analysis, legal contract review, contract language and rate negotiations/re-negotiations, contract implementation and maintenance, health plan delegated credentialing, and ongoing support of the client relationship.
  • Establishes and maintains a strong, open and positive working relationship with external Managed Care plan executives and staff
  • Works with newly acquired facility and ancillary providers to facilitate integration of Managed Care contracts.
  • Mentors and encourages professional development of team members.
  • Develops and implements operational plans consistent with the overall corporate goals and objectives.
  • Provides input, recommendations, and actively participates in development of corporate strategic plans and Managed Care contracting decisions.
  • Establishes Critical Success Factors for Managed Care contracting.
  • Consistently monitors and takes corrective action to ensure standards are met or exceeded.
  • Participates with management, medical staff, and clinical areas in decision making structure and process.
  • Functions as a resource to management by providing timely and accurate Managed Care market and contract information to assist in the full accomplishment of their goals and objectives.
  • Keeps abreast of current issues and trends in the Managed Care environment on the local, state, and national levels.
  • Supports all established policies, procedures, goals and objectives of Centers Health Care.
  • Performs all other duties as assigned.
  • Participates in Managed Care & Skilled Nursing Facilities associations to keep abreast of current issues and trends affecting Managed Care.

 

Other Requirements:

  • Bachelor's Degree required
  • Current driver’s license (This job requires travel)
  • Minimum of eight (8) years’ experience in Managed Care contract negotiations and operations.
  • Three (3) years’ experience in management and supervision of staff.

 

LOCATION:

Bronx, NY

 

Centers Health Care is the only fully integrated post-acute continuum of care, offering services to the elderly throughout NY, NJ and RI through its Healthcare facilities & agencies, Dialysis & Urgent Care Centers, a Managed Care Plan and a Durable Medical Equipment Provider. Earning praiseworthy reviews as the leading provider of top quality medical care in rehabilitative treatment and healthcare, Centers Health Care is unwavering in our dedication to excellence in care, and proud of our commitment to diversity and community involvement.

 

CentersHealthCare.com/careers

Equal Opportunity Employer –M/F/D/V

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