Managed Care Finance Director jobs in Philadelphia, PA

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)

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MOMobile Managed Care Program Manager
  • Maternity Care Coalition
  • Philadelphia, PA FULL_TIME
  • Organizational Summary

    In 1980, a group of Philadelphia health and social justice activists came together over concerns about the well-being of pregnant people and infants. They created Maternity Care Coalition (MCC) and advocated for change with policymakers and decision makers.


    Today, we continue to center children and their families by supporting, referring, educating, researching, and advocating.


    Position Summary
    Responsible for day-to-day operations of the MOMobile Managed Care program. Provides leadership in conducting outreach, follow-up, and home visiting to identify pregnant women and families with young children and provide appropriate services.

    Benefits include:
    • Three (3) weeks paid vacation, plus One (1) week paid Winter Break
    • Medical, Dental, Vision, Voluntary & Supplemental Life Insurance through CIGNA
    • Cafeteria Plan through Benefit Wallet: FSA and Commuter plans

    Essential Functions

    • Manages and monitors all MOMobile Managed Care activities and ensures quality of services.
    • Provides supervision to managed care advocates and student intern(s).
    • Responsible for recruitment and hiring of managed care advocates.
    • Acts as a community liaison between MCC, clients, and Medicaid managed care organizations (MCOs) and manages referrals from MCO partners.
    • Routinely communicates with MCO providers and schedules monthly/bi-monthly check-in meetings.
    • Oversees the contract scope of services with MCO partners.
    • Prepares and submits all reports and invoices as required by funders.
    • Develops and monitors program budgets and spending.
    • Communicates and coordinates contract requirements with other MCC program managers.
    • Facilitates regular staff meetings and conducts individual supervisory meetings.
    • Conducts regular home visit observations.
    • Provides direct services to a small caseload when needed.
    • Regularly reviews client files and provides feedback to staff.
    • Prepares performance evaluations with input from staff.
    • Identifies staff training needs and writes yearly training plans.
    • May be required to travel the eight-county region

    Other Tasks

    • Adheres to the MCC’s security guidelines and ensures the appropriate handling of sensitive information.
    • Attends relevant staff meetings to promote communication and execution of goals.
    • Completes special projects specific to the function of the department or as needed for the department as directed by the supervisor.
    • Other duties as assigned within the scope of position expectations.

    Knowledge, Skills, and Abilities

    • Understanding of MCC’s mission, goals, and objectives and ability to work independently with a high level of energy and contribute as part of a larger team.
    • Knowledge of the concepts and practices associated with community health issues, particularly with pregnant women, prenatal care, parenting and other services for mothers, young children, and their families.
    • Ability to travel in and around the Greater Philadelphia region to conduct home visits and community outreach.
    • Knowledge of and sensitivity to issues facing the community served.
    • Experience in client management procedures for determining eligibility, assessing needs, identifying resources, making referrals, following up, and documenting client interactions.
    • Demonstrated clinical social work skills.
    • Strong interpersonal skills as demonstrated by compassionate, courteous, cordial, cooperative, and professional interaction with diverse groups of co-workers, community partners, clients, and members of the community.
    • Ability to operate a computer and use a variety of common software programs including Microsoft Office, spreadsheets, and customized databases.
    • Effective and accurate documentation of case notes and client data according to established client management documentation procedures.
    • Ability to organize tasks in an efficient manner and follow-up and follow-through with strong attention to detail.
    • Proficient with Microsoft Office Suite, ability to operate a computer and use a variety of common software programs a must
    • Experience utilizing virtual meeting platforms
    • This is a telecommuting position. Staff are required to be onsite at least (1) day a week (you can add your requirement). In addition, staff must establish a safe and supportive workspace at home.

    Experience, Education, and Licensure

    • Master’s degree in social work or related field strongly preferred; bachelor’s degree required.
    • 2 years of supervisory experience preferred
    • Valid driver’s license
  • 15 Days Ago

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Director of Managed Services
  • Latitude, Inc.
  • Broomall, PA FULL_TIME
  • Director of Managed Services Main Points Mostly onsite position in Broomall, PASalary: 100k-140k depending on experience "command" and "control" experience required Overview:The Director of Managed Se...
  • 22 Days Ago

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Director, Managed Services
  • IT Solutions Consulting LLC
  • Fort Washington, PA FULL_TIME
  • About Us: IT Solutions Consulting, LLC is a Managed Services and Application Development company with over 25 years of experience. We provide reliable and secure IT support and strategic technology gu...
  • 1 Month Ago

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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Philadelphia, PA FULL_TIME
  • We are currently seeking a skilled and motivated Pharmacist with expertise in Pharmacy Benefit Management (PBM) and Managed Care. In this pivotal role, you will be responsible for overseeing medicatio...
  • 1 Month Ago

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Director, Housing Loan Program
  • Nonprofit Finance Fund
  • Philadelphia, PA FULL_TIME
  • Position Reports to: Vice President, Financing Location: Preference is for the position to be in commutable distance to one of NFF’s office locations which are Boston, Los Angeles, New York, Oakland, ...
  • 22 Days Ago

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Managed Security Service Offerings Director
  • IT Solutions Consulting LLC
  • Fort Washington, PA FULL_TIME
  • About ITS: Are you ready to be a part of something extraordinary? IT Solutions is a Managed Service Provider specializing in proactive and strategic IT support for small to mid-market businesses—but w...
  • 7 Days Ago

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0 Managed Care Finance Director jobs found in Philadelphia, PA area

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Finance Director
  • Clinigen
  • Malvern, PA
  • Clinigen is a rapidly growing global specialty pharmaceutical and services company with a unique combination of business...
  • 4/22/2024 12:00:00 AM

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CFO - Central Maryland
  • Kreischer Miller
  • Horsham, PA
  • About Kreischer-Miller: Kreischer Miller's Retained Executive Search Group (RES) takes a highly personalized and collabo...
  • 4/22/2024 12:00:00 AM

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Chief Financial Officer (CFO)
  • RiteChoice Pharmacy
  • Philadelphia, PA
  • The ideal candidate will be responsible for financial strategy, financial planning and analysis, financial reports, comp...
  • 4/21/2024 12:00:00 AM

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Associate Finance Director
  • Esperanza Health Center
  • Philadelphia, PA
  • Job Description Job Description SUPERVISOR: Finance Director FLSA STATUS: Exempt DEPARTMENT: 100400 SUMMARY: The Associa...
  • 4/20/2024 12:00:00 AM

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Finance Director
  • Clinigen
  • Malvern, PA
  • Clinigen is a rapidly growing global specialty pharmaceutical and services company with a unique combination of business...
  • 4/20/2024 12:00:00 AM

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Finance Director - Titanium Technologies
  • Chemours
  • Wilmington, DE
  • As we create a colorful, capable and cleaner world through chemistry, we invite you to join our team to harness the powe...
  • 4/19/2024 12:00:00 AM

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Executive Assistant to CFO
  • WES Health System
  • Philadelphia, PA
  • Job Description Job Description GENERAL OVERVIEW OF KEY ROLES & RESPONSIBILITIES: The Executive Assistant will perform a...
  • 4/19/2024 12:00:00 AM

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Finance Director - Personal Investor Planning & Reporting
  • Vanguard
  • Malvern, PA
  • This Finance Director leads Vanguard’s FP&A Personal Investor Division’s planning and reporting team on behalf of the Bu...
  • 4/17/2024 12:00:00 AM

Philadelphia, sometimes known colloquially as Philly, is the largest city in the U.S. state and Commonwealth of Pennsylvania, and the sixth-most populous U.S. city, with a 2017 census-estimated population of 1,580,863. Since 1854, the city has been coterminous with Philadelphia County, the most populous county in Pennsylvania and the urban core of the eighth-largest U.S. metropolitan statistical area, with over 6 million residents as of 2017[update]. Philadelphia is also the economic and cultural anchor of the greater Delaware Valley, located along the lower Delaware and Schuylkill Rivers, wit...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Finance Director jobs
$150,625 to $194,628
Philadelphia, Pennsylvania area prices
were up 1.0% from a year ago

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