CONTRACTS MGR CHN
HR Use Only: Contracts Manager - Managed Care
Hospital: Cleveland Clinic Main Campus & Family Health Centers
Facility: INDEPENDENCE WEST CREEK MCO
Department: MANAGED CARE
Job Code: T31085
Pay Grade: 16
Schedule: Full Time
Hours: 8am - 5pm
Under the direction of the Director of Contracting, is responsible for the negotiation and renegotiation of managed care contracts. Oversees and coordinates the administrative, legal, operational, and financial issues related to contract negotiation. Maintains a comprehensive payor and managed care intelligence database. Develops responses to request for proposals from managed care plans. Facilitates the creation of managed care educational and training materials for payer contract services, physicians, physician office managers and other participating provider personnel.
Education: Bachelor’s Degree required, Master’s Degree preferred with focus in healthcare finance, marketing, administration or related field.
Experience: Minimum of 3 years managed care contracting experience in a payor or provider setting including negotiation of financial/contract terms and development of contract language. Working knowledge of leading edge managed care methodologies and practices. Working knowledge of managed care operations, physician office practices, as well as hospital admitting, billing, and utilization review operation is essential. Negotiation skills, outstanding analytical ability and financial skills. Effective communication, organization, and interpersonal skills essential, must be able to work with confidential information, accuracy is essential, must be detail oriented. PC skills necessary with experience in Microsoft Office products. Excellent oral and written communication skills.
Licensure/Certification: None required.
Physical Requirements: Manual dexterity to operate office equipment. Ability to lift and transport up to 15 pounds. May require extended periods of standing, walking or siting. Good visual acuity through normal or corrected vision.
HR Use Only: #LI-NB1
Cleveland Clinic - 11 months ago
Cleveland Clinic, located in Cleveland, Ohio, is a not-for-profit multispecialty academic medical center that integrates clinical and...