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MANAGER MANAGED CARE CONTRACTS

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Job Description

This position may involve support of various hospitals and health care systems within the UNC Health Care System, but will be employed by Rex Hospital, Inc. (this includes, but is not limited to, for purposes of payroll, health benefits, retirement options, and applicable policies)

The Managed Care Contracts Manager is a key position in the Managed Care Department and represents the breadth of UNC Health Care System’s services – physicians, ancillaries and facilities. The position supports UNC Health Care System’s goals of patient access and financial responsibility by maintaining high-performing contracts with managed health care payers.

Responsibilities include:

• Identifying contracting opportunities so that new and existing patients may come to UNC Health

  Care;
• Building relationships with payers to facilitate effective communication and problem-solving

  regarding contracts;
• Reviewing contract language to ensure compliance with internal guidelines and sound business

  practices;
• Consulting with clinical and business units to assess if contract terms are realistic;
• Analyzing contract financial data for consistency with strategic objectives;
• Negotiating revised contract terms that are favorable to UNC Health Care System;
• Presenting contract summaries to key executives to win buy-in and make go/no-go decisions;
• Explaining contract requirements to internal constituents.

Four-five years of experience working for either a managed health care payer or a health care provider system in a contracting or provider/payer relations position is ideal. Knowledge of the commercial and governmental managed health care industry, including fee-for-service, value-based, and at-risk payment models is a must, and familiarity with health system operations is highly desired.

Qualifications

Bachelor’s degree in relevant field. Requires five (5) years of experience in contract negotiation and/ or managed care.

 

If a master's degree, requires three (3) years of experience in contract negotiation and/or managed care.

Primary Location: Chapel Hill, North Carolina, United States

Department: U-70030-MANAGED CARE-140

Shift: Day Job

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  • Management- Non-Clinical, Chapel Hill, North Carolina, United StatesRemove