MANAGER MANAGED CARE CONTRACTSApply Now Email Job Current employees click here Job ID: OTH01MFD
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.
• Identifying contracting opportunities so that new and existing patients may come to UNC Health
• Building relationships with payers to facilitate effective communication and problem-solving
• Reviewing contract language to ensure compliance with internal guidelines and sound business
• 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.
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