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Managed Care Contract Manager - 4709 in Brentwood, TN at PathGroup

Date Posted: 11/10/2018

Job Snapshot

Job Description

Work schedule:

Monday-Friday   8:00am to 5:00pm

JOB SUMMARY:

The Managed Care Contract Manager works with the Managed Care team to negotiate payer contracts and rates in support of the overall strategy and direction of the Managed Care department.  The Managed Care Contract Manager oversees the critical functions related to provider network operations, including but not limited to provider on- boarding, interpreting and coordinating the implementation of contract rates and other terms to load into the claims payment system. 

JOB RESPONSIBILITIES

ESSENTIAL FUNCTIONS:

  • Support PathGroup’s mission, vision, goals and management decisions.
  • Negotiate/renegotiate new and existing payer contract rates.
  • Develop contracts/amendments/notifications in support of physician/hospital clients.  
  • Establish and maintain relationships with payers, Network Development personnel to facilitate initial contract implementation, resolve issues and monitor improve process.
  • Attend payer meetings and engage in face to face contact with key payer personnel quarterly.
  • Assist business operations in adherence to contract terms and mutual expectations and educating company key personnel about such contract terms and expectations.
  • Assist in internally communicating new contracts, rates lines of business
  • Work closely with sales and marketing staff in the support/development of new/existing client payer questions and concerns
  • Develop strategic payer relationships.
  • Monitor compliance of contracts with health care regulations and law.
Work Schedule
Mon-Fri 8:00am-5:00pm
 

Job Requirements

EDUCATION & LICENSURE:

  • Bachelor degree from an accredited college or University preferred. Major in Accounting, Finance or other related business field is a plus.

REQUIREMENTS:

  • Five to ten years’ experience in provider contracting managing the relationship with Network providers is required.
  • Experience working with legal counsel on contract negotiations is preferred.