Senior Managed Care Contracting Administrator

Job Description

Provides guidance and direction related to the development and analysis of fee for service (FFS) and risk based managed care contracts as well as Provider contracts. Addresses operational issues and reviews contract rates, contract terms and other relevant issues in order to facilitate the implementation of Provider and managed care contracts.

Job Responsibility

• Oversees development and implementation of FFS and risk managed care contracts and Provider contracts.
• Compiles and tracks managed care financial and statistical information related to contract development and financial impact analysis.
• Maintains rate database and contractual terms of managed care contracts (prosthetics and implants, MR copying charges, etc.).
• Collaborates with hospital departments and outside vendors to facilitate contract implementation.
• Facilitates the implementation of managed care contracts, including the auditing of the contract management systems in the Finance and Patient Accounting departments.
• Responds to inquiries and interprets contract language.
• Develops systems to track data in comprehensive and innovative ways.
• Maintains and updates contract reimbursement and billing codes by working with appropriate on-site departments.
• Operates under limited guidance and work assignments involve moderately complex to complex issues where the analysis of situations or data requires in-depth evaluation of variable factors.
• Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.

Job Qualification

• Bachelor's Degree required, or equivalent combination of education and related experience.
• 3-5 years of relevant experience, required.

*Additional Salary Detail

The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).