• Find preferred job with Jobstinger
  • ID
    #4869255
  • Salary
    TBD
  • Source
    ProMedica Health System
  • Date
    2020-09-23
  • Deadline
    2020-11-21

Vacancy expired!

Position SummaryWorking with the Manager and Director of Managed Care, this position is responsible for developing and implementing managed care strategies and relationships designed to maintain and grow the ProMedica Health System (PHS), which comprises a network of hospitals, primary care and specialty providers, ancillary services, and a clinically integrated network (ProMedica Health Network). Objective is to provide best in class managed care contracting, analytics, education, and service.Primary Duties

Support Managed Care team with matters relating to external providers, plan sponsors, regulatory agencies, managed care payors, business development, and the community

Create power point or other presentation materials for internal and external meetings

Analyze relevant data to provide in reports, which may include determining the impact of adjustments to managed care reimbursement terms and/or contract compliance

Support value based contracting relationships and clinical integration efforts

Report value based contracting and physician hospital organization (PHO) finances

Work collaboratively with hospital, ProMedica Physician Group (PPG) and other PHS business teams, with goal to deliver cross-functional outcomes

Serve as a business liaison to managed care payors, PHS providers and facilities to facilitate provider registration in managed care plans and support effective resolution of managed care issues

Identify and recommend improvements in processes for greater operational efficiency

Maintain various department spreadsheets and databases

Organize, schedule, complete agenda and meeting minutes for operational meetings

Review managed care payor provider directories and updates

Assume other projects and assigned job duties related to managed care, as needed

High School Graduate required.

Bachelor’s degree preferred.

Health care reimbursement experience in a health system, consulting firm, or with a managed care payor preferred.

Knowledge of basic Microsoft Office tools required.

Understanding of PHS information systems preferred.

Great communication and analytical skills required.

Ability to accurately and independently identify problems as demonstrated by taking a basic skills test and scoring a minimum of 80%

Must be able to function both independently and as a team member

Self-motivation and willingness to learn

ProMedica is a mission-based, not-for-profit health and well-being organization headquartered in Toledo, Ohio. It serves communities in 28 states. The organization offers acute and ambulatory care, an insurance company with a dental plan, and post-acute and academic business lines. The organization has more than 49,000 employees, 13 hospitals, 2,500+ physicians and advanced practice providers with privileges, 1,000+ healthcare providers employed by ProMedica Physicians, a health plan, and 330+ assisted living facilities, skilled nursing and rehabilitation centers, memory care communities, and hospice and home health care agencies. Driven by its Mission to improve your health and well-being, ProMedica has been nationally recognized for its advocacy programs and efforts to address social determinants of health. For more information about ProMedica, please visit www.promedica.org/aboutus. Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex, pregnancy, sexual orientation, gender identity or gender expression, age, disability, military or veteran status, height, weight, familial or marital status, or genetics.Equal Opportunity Employer/Drug-Free WorkplaceRequisition ID: 52126

Vacancy expired!

Report job

Related Jobs

Jobstinger