Managed Care - Contracting Manager, West Coast
Managed Care, Contracting Manager - West Coast [reference - Contracting Manager]
The primary focus of the Managed Care, Contract Manager is responsible for reaching out to providers to develop a network and evaluate, negotiate, and implement new contracts. Reporting to the Head of Managed Care & Reimbursement, the Contracting Manager must have experience in the molecular diagnostics or clinical laboratory industry working with contract development, contracting administration, reimbursement analysis or medical policy. Experience working with both commercial and government payers is preferred.
• Solid understanding of the health care industry, market imperatives and trends for healthcare providers. Ability to perform managed care contract analysis, review and interpret contractual language provisions, and support department initiatives.
• Work with National, Regional, and Government programs to establish coverage policies and secure reimbursement.
• Assist in internal education and support all cross-function initiatives.
• Demonstrated ability to negotiate Managed Care contracts and develop and draft contract language.
• Analyze current claims data to facilitate preferred provider agreements with key health plans.
• Must have the ability to work independently, prioritize multiple objectives and tasks in a rapidly changing environment and deliver quality outcomes.
Education and Experience Requirements:
• Bachelor Degree in Business, Finance, or Healthcare.
• Minimum of five (5) years business experience within the health care industry working successfully with National and Regional payers on reimbursement agreements.
• Experience working with government and commercial payers through past work in billing, contract administration, coverage policy or contracting.
• Must possess exceptional organizational and presentation skills.
• Effective verbal and written communication skills.
• Excellent technology skills, specifically in Word/Excel.
• Strong management and leadership skills.
• Understanding of HIPAA compliance and confidentiality policies and procedures.
• Ability to travel 25%
What we offer:
• Competitive salary, expense reimbursement, and benefits package within a dynamic and growing company that is committed to improving patient healthcare.
• Opportunities to enhance your career with an emerging organization poised for significant growth.