Managed Care Contracting Representative (Melville)

  • Address:Melville, NY 11747 (map)
  • Date Posted:08/25/16
  • Job Type:Full-time
  • Description:
  • Position Requirements : Responsibilities will include: • Assist in the development and implementation of Managed Care, IPA, and Payor Contracts on a national, regional, and local level. • Negotiate and renegotiate managed care and payor contracts consistent with contracting goals. • Development of decision support materials and proposals. • Review and analysis of contractual language and reimbursement terms in existing and potential managed care agreements, including rate modeling and analysis. • Cultivate relationships and maintain communications with health plans and payors. • Prepare various reports to track and monitor financial performance of contracts. • Assist to maintain and organize the managed care contracting database, disseminate contract rates and information to designated individuals for adherence to contract terms and definitions. • Assist with the investigation and evaluation of payor markets in different states (payor mix, reimbursement issues, and state regulatory statutes). • Prepare reports to review, assess and analyze utilization trends and overall performance of group contracts. The ideal candidate will have knowledge of healthcare delivery issues, managed care, and current regulations; willingness to travel and work to "get the job done"; strong negotiation and interpersonal skills; strong written, verbal and analytical skills; motivated and proactive strategist with the ability to adhere to deadlines; professional business sense and presentation skills; strong knowledge of reimbursement methodology types (i.e. case rates; fee for service etc); must be proficient in creating and utilizing MS Excel spreadsheets and all other MS Office programs. Bachelor's Degree required, and minimum of 5 years related exp erience.
Ad ID: 45749073
  • Posted by: Ad Partner | View all ads
  • Profile: Active since 08/2016
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