Memorial Healthcare System
Managed Care Senior Manager - FT - Days - MHS
Memorial Healthcare System, Florida, New York, United States
Managed Care Senior Manager - FT - Days - MHS
At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary Corporate level manager responsible for deploying and contributing to strategic and tactical initiatives for negotiations with national and regional payors. Manages execution of contracting initiatives for integrated delivery system to drive positive financial trend and to achieve an appropriate market price point on behalf of health system's acute care, ancillary and professional providers. Responsibilities Execute, contribute and manage complex legal, financial and operational contract language negotiations in concert with the Director of Managed Care or independently as applicable to the negotiation. Execute contracting strategies for all service lines in Memorial Hospitals, MHS employed physicians, transplant programs, and ancillary services. Direct and analyze financial performance, reports and models, quality metrics and cost savings for negotiations with national and regional payors. Plan and monitor activities of staff and team members including hiring, orienting, training, mentoring, continuing education, evaluating, coaching and disciplinary actions, as applicable. Enhance, estimate and preserve net revenues. Assure financial viability of contracts through financial analysis and forecasting in conjunction with Financial Analyst(s), contract negotiations and issue resolution. Execute strategies and guides operations to protect and build market share. Competencies ACCOUNTABILITY, BUILDING A BUSINESS CASE, CONTRACTING - MANAGED CARE PAYORS, CUSTOMER SERVICE, FINANCIAL COUNSELING - PATIENT SERVICES, HEALTHCARE REGULATORY ENVIRONMENT, LEADING CHANGE INITIATIVES, MANAGED CARE PAYOR MANAGEMENT, MANAGING BUSINESS PRIORITIES, MANAGING INFORMATION, PEOPLE MANAGMENT, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR Education And Certification Requirements Bachelors (Required) Additional Job Information Complexity of Work: Requires critical and flexible thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a fast paced, high energy environment while multitasking, working independently and delivering quality outcomes. Must have strong technical & financial skills, negotiating skills and knowledge of contract language (develop, draft and interpret) and reimbursement terms. Extensive Managed Care Industry knowledge and understanding of hospital and insurance industries. Ability to work collaboratively in a collegial environment with multiple stakeholders to achieve department and organization goals. Required Work Experience: Five (5) years contracting experience with three (3) years contracting for hospital, professional services, ancillary facilities or specialty networks. Working Conditions And Physical Requirements
Bending and Stooping = 40% Climbing = 20% Keyboard Entry = 60% Kneeling = 20% Lifting/Carrying Patients 35 Pounds or Greater = 0% Lifting or Carrying 0 - 25 lbs Non-Patient = 20% Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 0% Lifting or Carrying > 75 lbs Non-Patient = 0% Pushing or Pulling 0 - 25 lbs Non-Patient = 20% Pushing or Pulling 26 - 75 lbs Non-Patient = 0% Pushing or Pulling > 75 lbs Non-Patient = 0% Reaching = 0% Repetitive Movement Foot/Leg = 0% Repetitive Movement Hand/Arm = 60% Running = 0% Sitting = 60% Squatting = 20% Standing = 60% Walking = 40% Audible Speech = 60% Hearing Acuity = 60% Smelling Acuity = 0% Taste Discrimination = 0% Depth Perception = 60% Distinguish Color = 60% Seeing - Far = 60% Seeing - Near = 60% Bio hazardous Waste = 0% Biological Hazards - Respiratory = 0% Biological Hazards - Skin or Ingestion = 0% Blood and/or Bodily Fluids = 0% Communicable Diseases and/or Pathogens = 0% Asbestos = 0% Cytotoxic Chemicals = 0% Dust = 20% Gas/Vapors/Fumes = 0% Hazardous Chemicals = 0% Hazardous Medication = 0% Latex = 0% Computer Monitor = 60% Domestic Animals = 0% Extreme Heat/Cold = 0% Fire Risk = 0% Hazardous Noise = 0% Heating Devices = 0% Hypoxia = 0% Laser/High Intensity Lights = 0% Magnetic Fields = 0% Moving Mechanical Parts = 0% Needles/Sharp Objects = 0% Potential Electric Shock = 0% Potential for Physical Assault = 0% Radiation = 0% Sudden Decompression During Flights = 0% Unprotected Heights = 0% Wet or Slippery Surfaces = 20% Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity. Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, gender identity or expression, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law.
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At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary Corporate level manager responsible for deploying and contributing to strategic and tactical initiatives for negotiations with national and regional payors. Manages execution of contracting initiatives for integrated delivery system to drive positive financial trend and to achieve an appropriate market price point on behalf of health system's acute care, ancillary and professional providers. Responsibilities Execute, contribute and manage complex legal, financial and operational contract language negotiations in concert with the Director of Managed Care or independently as applicable to the negotiation. Execute contracting strategies for all service lines in Memorial Hospitals, MHS employed physicians, transplant programs, and ancillary services. Direct and analyze financial performance, reports and models, quality metrics and cost savings for negotiations with national and regional payors. Plan and monitor activities of staff and team members including hiring, orienting, training, mentoring, continuing education, evaluating, coaching and disciplinary actions, as applicable. Enhance, estimate and preserve net revenues. Assure financial viability of contracts through financial analysis and forecasting in conjunction with Financial Analyst(s), contract negotiations and issue resolution. Execute strategies and guides operations to protect and build market share. Competencies ACCOUNTABILITY, BUILDING A BUSINESS CASE, CONTRACTING - MANAGED CARE PAYORS, CUSTOMER SERVICE, FINANCIAL COUNSELING - PATIENT SERVICES, HEALTHCARE REGULATORY ENVIRONMENT, LEADING CHANGE INITIATIVES, MANAGED CARE PAYOR MANAGEMENT, MANAGING BUSINESS PRIORITIES, MANAGING INFORMATION, PEOPLE MANAGMENT, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR Education And Certification Requirements Bachelors (Required) Additional Job Information Complexity of Work: Requires critical and flexible thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a fast paced, high energy environment while multitasking, working independently and delivering quality outcomes. Must have strong technical & financial skills, negotiating skills and knowledge of contract language (develop, draft and interpret) and reimbursement terms. Extensive Managed Care Industry knowledge and understanding of hospital and insurance industries. Ability to work collaboratively in a collegial environment with multiple stakeholders to achieve department and organization goals. Required Work Experience: Five (5) years contracting experience with three (3) years contracting for hospital, professional services, ancillary facilities or specialty networks. Working Conditions And Physical Requirements
Bending and Stooping = 40% Climbing = 20% Keyboard Entry = 60% Kneeling = 20% Lifting/Carrying Patients 35 Pounds or Greater = 0% Lifting or Carrying 0 - 25 lbs Non-Patient = 20% Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 0% Lifting or Carrying > 75 lbs Non-Patient = 0% Pushing or Pulling 0 - 25 lbs Non-Patient = 20% Pushing or Pulling 26 - 75 lbs Non-Patient = 0% Pushing or Pulling > 75 lbs Non-Patient = 0% Reaching = 0% Repetitive Movement Foot/Leg = 0% Repetitive Movement Hand/Arm = 60% Running = 0% Sitting = 60% Squatting = 20% Standing = 60% Walking = 40% Audible Speech = 60% Hearing Acuity = 60% Smelling Acuity = 0% Taste Discrimination = 0% Depth Perception = 60% Distinguish Color = 60% Seeing - Far = 60% Seeing - Near = 60% Bio hazardous Waste = 0% Biological Hazards - Respiratory = 0% Biological Hazards - Skin or Ingestion = 0% Blood and/or Bodily Fluids = 0% Communicable Diseases and/or Pathogens = 0% Asbestos = 0% Cytotoxic Chemicals = 0% Dust = 20% Gas/Vapors/Fumes = 0% Hazardous Chemicals = 0% Hazardous Medication = 0% Latex = 0% Computer Monitor = 60% Domestic Animals = 0% Extreme Heat/Cold = 0% Fire Risk = 0% Hazardous Noise = 0% Heating Devices = 0% Hypoxia = 0% Laser/High Intensity Lights = 0% Magnetic Fields = 0% Moving Mechanical Parts = 0% Needles/Sharp Objects = 0% Potential Electric Shock = 0% Potential for Physical Assault = 0% Radiation = 0% Sudden Decompression During Flights = 0% Unprotected Heights = 0% Wet or Slippery Surfaces = 20% Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity. Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, gender identity or expression, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law.
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