Director Managed Care Contracting
AccentCare, Inc.
Overview Find Your Passion and Purpose as a Director Managed Care Contracting Reimagine Your Career in Corporate Healthcare As a professional, you know that what you do impacts you as much as our patients and their families, and at AccentCare, we are united in our relentless drive to reimagine care because we want to provide the service we would seek for our own families. We think it’s really special to be a part of our patient’s health journey and create incredible memories while providing world-class patient care. Offer Based on Years of Experience What You Need to Know The Director of Managed Care is responsible for negotiation and management of payer contracts for AccentCare Home Health, Hospice and Palliative Care entities, including proposal preparation and direct interface with managed care payers . The position is directly responsible for developing the negotiation strategy, forecasted financial impact and managing the negotiation process through implementation. The position will work with internal departments, including Operations, Finance, Revenue Cycle and Legal to develop the contract negotiation strategy and to manage the implementation process post negotiation. This position is responsible for monitoring the performance of managed care contracts and is responsible for contributing to the annual budget process. Advises management of contractual rights and obligations and provides interpretation of terms and conditions. Develop negotiation strategy and related financial projection for managed care payers Lead the negotiation process for assigned geographic territory and/or specific payers. Manage the internal communication process post negotiation, including oversight of the credentialing process through completion. Coordination of contract consolidations due to acquisitions, change of business lines, addition and deletion of AccentCare locations Maintain contract database in an organized fashion that allows other MC team members and departments access to related contract details. Provide proactive education to the sites and corporate departments about payer contracts and any complex reimbursement issues Create new payer codes and communicate to agencies and billing department Facilitate financial analysis of high-volume contracts as assigned Manage payer risk relationships and assist with managing accounts receivables Schedule regular in person and or phone follow up and periodic meetings with MCO, State and Federal customers to ensure AccentCare performance meets their needs All other duties, as assigned Our Investment in You We are committed to offering comprehensive benefits and rewards to full-time employees who work over 30 hours per week and their families, including: Medical, dental, and vision coverage Paid time off and paid holidays Professional development Company-matching 401(k) Flexible spending and health savings accounts Qualifications Be the Best Director Managed Care Contracting You Can Be If you meet these qualifications, we want to meet you! Bachelor’s degree 5-10 years of experience in healthcare related to government contracting, consulting or managed care Home Health Care Background or Insurance Plan Background required-if coming from provider side must demonstrate knowledge of payers. Knowledge of commercial, Medicaid and Medicare HMO’s, PPO’s and alternative financing programs Hands on experience with various types of proposal pricing with strong Microsoft skills Strong analytical, communication and presentation skills with demonstrated track record of successful management Communication and follow up skills are critical, ability to push back and garner buy in. Strong work ethic and proven track record of stability within an organization Ability to multi-task and prioritize projects Requires an organized and articulated individual who has a strong attention to detail and is able to set and meet deadlines Skilled at relationship management with key internal and external partner/contract entities Come As You Are At AccentCare, our care is most compassionate when we empathize and engage with everyone, and we are at our best when we value diverse perspectives, foster open dialogue, and enact change. And we are stronger when each of us is empowered to grow, be our unique selves, and feel a sense of inclusion and belonging. AccentCare is proud of how we are building a culture and inclusive infrastructure to help elevate the voice of all our employees with a special focus on the underrepresented and marginalized. We offer equal employment opportunities regardless of a person’s race, ethnicity, sex, sexual orientation, gender identity or expression, religion, national origin, color, creed, age, mental disability, physical disability, or any other protected classification.
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