Apply Now Manager Managed Care Job in Irving

Summary:

This position is responsible for providing operational support on managed care contracts as assigned by System Director or Director. The incumbent will be responsible for working directly with managed care payers and PFS to resolve claim payment and administrative issues occurring with managed care contracts. The incumbent will work collaboratively with Vice President Managed Care, Managed Care Team, Revenue Integrity, and PFS management.

Requirements:

• High School Diploma or equivalent required, Bachelor’s Degree preferred
• Excellent written and oral communication skills
• Excellent organizational skills
• Excellent training skills
• Solid understanding of managed care practices/principles, payer reimbursement methodologies (e.g. DRG, Per Diem, Case Rate, etc.) and managed care processes (e.g. authorizations, medical necessity, etc.) as differentiated by market segment
• At least five (5) years of experience in managed care and/or insurance organizations with experience in claims resolution, contracting, relationship development, and staff education.
• At least three (3) years of management experience, of people or projects
• At least five (5) years of experience in managed care and/or insurance organizations with experience in Government Programs. Required to have extensive knowledge of CMS guidelines, policies and updates.

Work Type: 

Full Time