LCMC Health
Manager, Managed Care
LCMC Health, New Orleans, Louisiana, United States, 70123
Your job is more than a job
Under the supervision of the LCMC System Director of Managed Care, the Manager of Managed Care is responsible for duties related to managed care contracting and employer relations operations. The Manager of Managed Care will participate in the development of the LCMC System contracting and employer relations strategy for hospitals and physicians. This position will provide support to the Director of Managed Care in evaluation of new payer agreements, establishing negotiations goals, negotiating contract renewals and deployment LCMC's employer relation strategy.
Your Everyday
Strategy:
Participates in development of and executes managed care and employer/broker strategy for LCMC hospitals and physicians.
Responsible for identifying opportunities for LCMC to grow market share.
Establishes productive business relationships with payor representatives and participates in JOCs.
Manages the planning process for contract renewals and negotiations including assessment of historical performance and issues as well as identification of payor specific issues.
Analysis:
Provides analysis and summary of reimbursement and language terms of payor contracts.
Works closely with analytics staff and legal counsel to review proposed agreements.
Ensure all documents associated with the negotiated payor agreement are in contract management systems correctly at all times.
Provide biweekly updates on significant payer issues.
Ensures that all deadlines for initial credentialing and renewals for hospital are met.
Employer Relations:
Supports LCMC’s employer and insurance broker relationship strategy.
Responsible to identify key payers, brokers, employers, and employee groups in the Hospitals primary and secondary service areas and develop relationships of trust within these groups in order to identify and advise them on market opportunities which would support LCMC’s growth strategy.
Assist in the development and presentation of LCMC Hospitals tactics to assist Payers, Brokers, and Employers in cost affective alternatives to consider during their benefit selection process and impact that decision making process.
The Must-Haves
Minimum:
EXPERIENCE QUALIFICATIONS
5 years of experience with Managed Care, Payor or Provider Contracting.
Experience in marketing insurance products and insurance benefit design is a plus.
EDUCATION QUALIFICATIONS
Bachelor’s Degree In Healthcare Management, Accounting, Business, or other related field
SKILLS AND ABILITIES
Excellent Excel skills and the ability to navigate through contract modeling software
Able to handle multiple tasks simultaneously, meet time sensitive deadlines and organize workload with limited supervision
Must have a working knowledge of current policies and guidelines that affect contracts, pricing in the managed care environment
Current working knowledge of Medicare reimbursement methodologies, fee schedule development, utilizing financial models and analysis in negotiating rates with payors
Knowledge of claims processing systems and guidelines
Excellent organization abilities as well as written and oral communication skills
Maintain strict confidentiality of sensitive information
Ability to interact and communicate with individuals at all levels of organization
Ability to complete projects independently within established time frames.
WORK SHIFT:
Days (United States of America)
LCMC Health is a community.
Our people make health happen. While our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way. Celebrating authenticity, originality, equity, inclusion and a little “come on in” attitude is the foundation of LCMC Health’s culture of everyday extraordinary.
You are welcome here.
LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.
The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.
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Under the supervision of the LCMC System Director of Managed Care, the Manager of Managed Care is responsible for duties related to managed care contracting and employer relations operations. The Manager of Managed Care will participate in the development of the LCMC System contracting and employer relations strategy for hospitals and physicians. This position will provide support to the Director of Managed Care in evaluation of new payer agreements, establishing negotiations goals, negotiating contract renewals and deployment LCMC's employer relation strategy.
Your Everyday
Strategy:
Participates in development of and executes managed care and employer/broker strategy for LCMC hospitals and physicians.
Responsible for identifying opportunities for LCMC to grow market share.
Establishes productive business relationships with payor representatives and participates in JOCs.
Manages the planning process for contract renewals and negotiations including assessment of historical performance and issues as well as identification of payor specific issues.
Analysis:
Provides analysis and summary of reimbursement and language terms of payor contracts.
Works closely with analytics staff and legal counsel to review proposed agreements.
Ensure all documents associated with the negotiated payor agreement are in contract management systems correctly at all times.
Provide biweekly updates on significant payer issues.
Ensures that all deadlines for initial credentialing and renewals for hospital are met.
Employer Relations:
Supports LCMC’s employer and insurance broker relationship strategy.
Responsible to identify key payers, brokers, employers, and employee groups in the Hospitals primary and secondary service areas and develop relationships of trust within these groups in order to identify and advise them on market opportunities which would support LCMC’s growth strategy.
Assist in the development and presentation of LCMC Hospitals tactics to assist Payers, Brokers, and Employers in cost affective alternatives to consider during their benefit selection process and impact that decision making process.
The Must-Haves
Minimum:
EXPERIENCE QUALIFICATIONS
5 years of experience with Managed Care, Payor or Provider Contracting.
Experience in marketing insurance products and insurance benefit design is a plus.
EDUCATION QUALIFICATIONS
Bachelor’s Degree In Healthcare Management, Accounting, Business, or other related field
SKILLS AND ABILITIES
Excellent Excel skills and the ability to navigate through contract modeling software
Able to handle multiple tasks simultaneously, meet time sensitive deadlines and organize workload with limited supervision
Must have a working knowledge of current policies and guidelines that affect contracts, pricing in the managed care environment
Current working knowledge of Medicare reimbursement methodologies, fee schedule development, utilizing financial models and analysis in negotiating rates with payors
Knowledge of claims processing systems and guidelines
Excellent organization abilities as well as written and oral communication skills
Maintain strict confidentiality of sensitive information
Ability to interact and communicate with individuals at all levels of organization
Ability to complete projects independently within established time frames.
WORK SHIFT:
Days (United States of America)
LCMC Health is a community.
Our people make health happen. While our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way. Celebrating authenticity, originality, equity, inclusion and a little “come on in” attitude is the foundation of LCMC Health’s culture of everyday extraordinary.
You are welcome here.
LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.
The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.
#J-18808-Ljbffr