Team Lead, Managed Care Operations
Raleigh
Overview:
The Managed Care Operations Lead serves as a resource and advisor, directs all aspects of managed care operations including system wide credentialing with managed care plans, contract performance monitoring and reporting, and contract payment modeling and analysis.
Works in collaboration with Chief Financial Officer, consultants Vice President of Finance, Director and Managed Care Specialists to recommend contracting strategies, perform complex contract modeling, and to monitor health plan performance.
The Managed Care Operations Lead serves as a resource and advisor, directs all aspects of managed care operations including system wide credentialing with managed care plans, contract performance monitoring and reporting, and contract payment modeling and analysis.
Works in collaboration with Chief Financial Officer, consultants Vice President of Finance, Director and Managed Care Specialists to recommend contracting strategies, perform complex contract modeling, and to monitor health plan performance.
Acts as a liaison between Managed Care Contracting, Reimbursement, Patient Financial Services, Patient Access and other departments in the hospital in an effort to create seamless operational performance and reimbursement maximization related to managed care contracting and performance monitoring.
Department Description:
Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care.For more information, visit www.wakemed.org.
EOE
Education:Bachelor's Degree Business Administration Or Healthcare Or Finance Or Related Field Required - And Master's Degree Health Administration Or Business Preferred
Experience: 10 Years Managed Care Contracting Required - With 7 Years Managed Care Contracting In Healthcare Required
Raleigh
Education: High School Diploma or Equivalent Required - And Associate's Degree Accounting Or Related Field Preferred
Experience: 4 Years Accounting/Finance - Billing Required - And Managed Care Contracting Preferred...
SAGA DiagnosticsMorrisville (NC), 11 mi from Raleigh
Requirements
Minimum Qualifications
• 10+ years of demonstrated success and diverse experience in marketing, sales and managed care, with positions of progressively greater scope and responsibility.
• 7+ years of experience leading and coaching people.
• 5...
Raleigh
for transfer of care when needed.
• Knowledge of managed care and insurance- as it relates to mental health benefits- is a plus.
• Outreach Associates must have the skills and competency to communicate with people at all levels of the organization; including...