Managed Care Finance Director directs and oversees all policies and procedures for the financial and data operations of managed care contracts. Manages contracts, negotiates and sets rates, and reviews reimbursement levels and managed care agreements to ensure that proper payment practices are utilized. Being a Managed Care Finance Director implements processes that encourage and inform the organization how to increase levels of reimbursements. Requires a bachelor's degree. Additionally, Managed Care Finance Director typically reports to top management. The Managed Care Finance Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Managed Care Finance Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)
Description
POSITION DESCRIPTION:
Responsible for providing and coordinating screening and care management interventions for patients identified with chronic, complex, care needs based on patient information provided by Managed Care Organizations (e.g. Aetna Medicare). Works collaboratively with the ACO Care Management team to implement evidence-based series, protocols, and methods for eligible patients. Responsible to assist with hospital follow up for FHC patients based on hospital discharge lists received from Lee Health and our contracted insurance plans. MCO Care Manager will be required to attend applicable insurance’s monthly or quarterly meeting and will have the chance to discuss their results, questions, and issues with the insurance reps during that time. The MCO Care Manager may also participate in other report analysis and patient contact projects, aimed at improving patient healthcare through increased contact and the scheduling of regular visits. Adheres to Corporate Compliance program, by reporting improper or unethical conduct, violation of applicable laws, regulations, or program requirements.
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Requirements
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0 Managed Care Finance Director jobs found in Fort Myers, FL area