Job Description

Description

Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.

Summary:
The Managed Care Contract Manager is responsible for all duties related to Managed care contracts. This position works closely with the Payer Contracting team to ensure all contracts are appropriately identified, negotiated, implemented, audited and renegotiated in a timely manner.

Responsibilities:
1. Contract Negotiation- Responsible for the development, coordination and analysis of managed care contracts. Negotiates reimbursement and language of payer contracts. Addresses operational issues and reviews contracts and terms in order to facilitate implementation. Analyzes contract financial data for consistency with strategic objectives. Establishes productive personal relationships with payer representatives. Understands and communicates contract specific issues of all payers. Ensure all documents associated with the negotiated payer agreement are in the appropriate systems accurately and performs audits on a regular basis to ensure accuracy. Manages the planning process for contract renewals and negotiations including assessment of historical performance as well as identification of payer specific issues. Assist with the analysis of payer mix information and utilization.
2. Contract Liaison- Presents contract summaries to key executives to win buy-in and make go/no-go decisions. Explains contract requirements to internal constituents. Consults with clinical and business units to assess if contract terms are realistic. Identifies new contracting opportunities for strategic growth
3. Communication- Works closely with other team members to ensure timely notification of changes to payers. Provide weekly contract status updates.

Other Information

Other information:
Education Requirements:
● Bachelor’s degree in relevant field
Licensure/Certification Requirements:
● No licensure or certification required.
Professional Experience Requirements:
● Requires five (5) years of experience in contract negotiation and/ or managed care.
● If a master's degree, requires three (3) years of experience in contract negotiation and/or managed care.
Knowledge/Skills/and Abilities Requirements:

Job Details

Legal Employer: NCHEALTH

Entity: Shared Services

Organization Unit: Managed Care

Work Type: Full Time

Standard Hours Per Week: 40.00

Salary Range: $43.04 - $53.80 per hour (Minimum to Midpoint)

Pay offers are determined by experience and internal equity

Work Assignment Type: Hybrid

Work Schedule: Day Job

Location of Job: US:NC:Morrisville

Exempt From Overtime: Exempt: Yes

This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job.