Responsible for analyzing and evaluating managed care plans.
Specifically responsible for developing comprehensive financial reports for evaluation as they relate to managed care, strategic and operational planning, long-range forecasting, billing and reimbursement management, developing financial trend analysis and contract analysisResponsibilities:- Prepare and analyze all financial data analysis necessary to negotiate with managed care payers, and proactively perform financial analytics and reports to evaluate the performance of current managed care agreements and provider agreements.- Maintain all physician fee schedules and contract information, including all necessary filing; verify and ensure accurate contract and fee schedule loading into the system operations on the implementation of contracts.- Provide any and all reports as needed to assist and coordinate studies of utilization, costs and reimbursement.- Prepare necessary reports and information to assist the Administrator for Board of Director meetings.- Monitor local and national managed care industry, and develops new managed care marketing strategies- Enhance current relationships with managed care companies and represent organization to the managed care industry.- Assist operations staff with daily issues that relate to contracting efforts.Qualifications:- Bachelor Degree required, Masters a plus- Minimum of 1 year performing managed care contracting with proven track record- Excellent financial analytical and computer skills, especially MS Excel- Knowledge of the Brevard County managed care payer market- Excellent communication, professional and organization skills- Detailed oriented, process thinker- Thorough knowledge of the managed care industry- Knowledge of medical terminology- Knowledge of practice management systems- Adequate knowledge of physician credentialing - Membership in healthcare professional associations