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Manager Acute & Ancillary Network Contracting

Location: Buffalo, NY, United States
Date Posted: Jun 17, 2020

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Job Description

Facility: Administrative Regional Training Cntr

Status: Full Time

Work Schedule: Days

Bargaining Unit: ACE Associates

Exempt from Overtime: Exempt: Yes

Hours:8-5

Shift: Shift 1:

FTE: 1.000000:



Summary:


The Manager Acute & Ancillary Network Contracting implements managed care strategies through negotiating contract rates and provisions for all Catholic Health (CH) acute and ancillary entities, in conjunction with Catholic Medical Partners (CMP) where applicable. This manager is responsible for the managed care contracting for approximately 75% of the System's managed care patient service revenue. The position ensures that contracts are operational and functional throughout the organization, collaborates to ensure payment accuracy, contract adherence and issue resolution with payers and internal stakeholders. Additionally, this individual will maintain a local presence at each ministry and handle the day to day tasks with health plans regarding contract terms, provider enrollment and credentialing, revenue cycle operations, and analytic support. The Manager Acute & Ancillary Network Contracting will support the development of managed care strategies and initiatives for CH to adapt to ongoing healthcare payment reforms and evolving payment methodologies, including accountable care organizations (ACOs) and clinically integrated networks (CINs). These functions include multidisciplinary interaction with various aspects of Catholic Health and Catholic Medical Partners as well as significant analysis and reporting functions related to the financial performance of payer contracts and related items. The Manager Acute & Ancillary Network Contracting will be responsible for ongoing communication throughout the organization related to managed care contracts and maintaining strong relationships with the hospital and System Finance team, Revenue Management Team and Business owners of Catholic Health. This position works closely with and share responsibilities related to managed care contracting and execution with the Professional & Alternative Payment Network Contracting Lead and government reimbursement team.



Responsibilities include management of analyst(s) performing analytics and modeling of managed care contracts, managing the negotiation process with managed care organizations, and active management and resolution of any managed care related issues or initiatives.



Responsibilities:


EDUCATION
  • Bachelor's degree minimum

EXPERIENCE
  • Three (3) to five (5) years healthcare experience required
  • Five (5) to ten (10) years healthcare experience preferred
  • Prior management experience preferred, but not required
  • Strong knowledge of healthcare reimbursement and billing practices preferred
  • Strong knowledge of risk/value based contracting and insurance negotiations preferred

KNOWLEDGE, SKILL AND ABILITY
  • Must be knowledgeable regarding managed care concepts, health care reimbursement, and financial analysis
  • Strong written and verbal communication skills required
  • Negotiation experience
  • Ability to take initiative in implementing new ideas, identify opportunities for improvement and to make innovative changes
  • Strong organizational skills
  • Proficiency in the use of technology (such as reporting tools, excel, word, power point and others)
  • Demonstrated strength in working with multidisciplinary teams

WORKING CONDITIONS
  • General office work, local travel, occasional early mornings and evenings required


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