Managed Care Supervisor jobs in Milwaukee, WI

Managed Care Supervisor supervises and coordinates activities of personnel in the managed care operations department of a healthcare facility. Oversees staff that process referrals, authorizations, billing, utilization review, and capitation for hospital services. Being a Managed Care Supervisor experienced in utilization review techniques and protocols. Requires a bachelor's degree. Additionally, Managed Care Supervisor typically reports to a manager or head of a unit/department. May require Registered Nurse (RN). Makes day-to-day decisions within or for a group/small department. Has some authority for personnel actions. The Managed Care Supervisor supervises a group of primarily para-professional level staffs. May also be a level above a supervisor within high volume administrative/ production environments. To be a Managed Care Supervisor typically requires 3-5 years experience in the related area as an individual contributor. Thorough knowledge of functional area and department processes. (Copyright 2024 Salary.com)

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MANAGED CARE CONTRACT COORD, FCH - MANAGED CARE
  • Froedtert Health
  • Menomonee Falls, WI FULL_TIME
  • Discover. Achieve. Succeed. #BeHere

    Location: US:WI:MENOMONEE FALLS at our WOODLAND PRIME 400 facility.

    This job is HYBRID.

    FTE: 1.000000

    Shift: 1st shift 8 am to 4:30 pm onsite Tuesday and Wednesday then work from home Monday Thursday, and Friday.

    Job Summary:
    The Managed Care Contract Coordinator acts as a liaison with managed care organizations (e.g., networks, insurers) and with internal customers, such as Patient Financial Services and Quality, to resolve issues related to reimbursement and managed care requirements. Other duties as assigned.

    The Managed Care Contract Coordinator manages the contracts with the insurance payers for the entire FH system. The position:

    *Works as a liaison by presenting contract summaries to the organization to explain contract reimbursement and contract terms to internal constituents.

    *Consults with clinical and business units to assess if contract terms are being followed.

    *Identifies new contracting opportunities for strategic growth.

    *Assists to negotiate reimbursement and language of payer contracts.

    *Addresses operational issues and provides contract language to support appeals to the Payer.

    *Establishes productive personal relationships with payer representatives and internal clinical/business staff.

    *Ensure all documents associated with the negotiation payer agreement are in appropriate system accurately and performs audits on a regular basis to ensure accuracy.

    *Other duties as assigned.

    EXPERIENCE DESCRIPTION:

    Three to five years of experience in a Health Care setting in either the payer or provider environment.

    Demonstrated ability in resolving complex issues is required.

    EDUCATION DESCRIPTION:

    Bachelor's degree in Business, Finance, Accounting or related field is required. In lieu of degree will consider 7 years of health care experience.

    SPECIAL SKILLS DESCRIPTION:

    Knowledge of managed care principles and the insurance industry is required.

    Ability to take initiative and exercise independent decision making.

    Strong communication skills and strong organizational skills are essential.

    Project management experience and strong PC skills including database management, spreadsheets and SharePoint editor.

    LICENSURE DESCRIPTION:

    Managed care certification is preferred.


    Perks & Benefits at Froedtert Health

    Froedtert Health Offers a variety of perks & benefits to staff, depending on your role you may be eligible for the following:

    • Paid time off
    • Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities
    • Academic Partnership with the Medical College of Wisconsin
    • Referral bonuses
    • Retirement plan - 403b
    • Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics
    • Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available


    The Froedtert & the Medical College of Wisconsin regional health network is a partnership between Froedtert Health and the Medical College of Wisconsin supporting a shared mission of patient care, innovation, medical research and education. Our health network operates eastern Wisconsin's only academic medical center and adult Level I Trauma center engaged in thousands of clinical trials and studies. The Froedtert & MCW health network, which includes ten hospitals, nearly 2,000 physicians and more than 45 health centers and clinics draw patients from throughout the Midwest and the nation.

    We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce. We welcome protected veterans to share their priority consideration status with us at 262-439-1961. We maintain a drug-free workplace and perform pre-employment substance abuse testing. During your application and interview process, if you have a need that requires an accommodation, please contact us at 262-439-1961. We will attempt to fulfill all reasonable accommodation requests.


    We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce. As a federal contractor/subcontractor, we take affirmative action in employment based on race, sex, disability and status as a protected veteran. We welcome protected veterans to share their priority consideration status with us at 262-439-1961. We maintain a drug-free workplace and perform pre-employment substance abuse testing

     

  • 1 Month Ago

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Airport Rental Car Cleaner ($15.00 per hour)
  • Managed Labor Solutions
  • Milwaukee, WI FULL_TIME
  • Do you enjoy late model cars, have a good attention to detail, and need a flexible schedule? Managed Labor Solutions (MLS), a leading nationwide rental car outsourcing company, is looking for high ene...
  • 13 Days Ago

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Airport Rental Car Fleet Driver ($12.00 per hour)
  • Managed Labor Solutions
  • Milwaukee, WI FULL_TIME
  • Do you enjoy working outside an office and are passionate about driving late-model cars? Need a flexible schedule plus access to DailyPay? Managed Labor Solutions (MLS), a leading nationwide rental ca...
  • 30 Days Ago

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Behavioral Case Manager
  • Managed Health Services Wisconsin / Centene
  • West, WI FULL_TIME
  • You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offeri...
  • 14 Days Ago

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Housekeeping & Laundry Supervisor
  • Crossroads Care Center of Mayville
  • Mayville, WI FULL_TIME
  • Responsibilities Assist the Plant Operation Manager with managing daily housekeeping and laundry operations, overseeing all housekeeping staff and preparing assignment sheets to ensure the cleanliness...
  • 22 Days Ago

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Housekeeping /Laundry Supervisor
  • Crossroads Care Center of Mayville
  • Mayville, WI FULL_TIME
  • JOB TITLE: Housekeeping/Laundry Supervisor - Full Time. REPORTS TO: Plant Operation Manager. POSITION SUMMARY: The Housekeeping /Laundry Supervisor is responsible for running the housekeeping and laun...
  • 22 Days Ago

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0 Managed Care Supervisor jobs found in Milwaukee, WI area

Milwaukee lies along the shores and bluffs of Lake Michigan at the confluence of three rivers: the Menomonee, the Kinnickinnic, and the Milwaukee. Smaller rivers, such as the Root River and Lincoln Creek, also flow through the city. Milwaukee's terrain is sculpted by the glacier path and includes steep bluffs along Lake Michigan that begin about a mile (1.6 km) north of downtown. In addition, 30 miles (48 km) southwest of Milwaukee is the Kettle Moraine and lake country that provides an industrial landscape combined with inland lakes. According to the United States Census Bureau, the city has ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Supervisor jobs
$75,690 to $104,461
Milwaukee, Wisconsin area prices
were up 1.8% from a year ago

Managed Care Supervisor in Austin, TX
The F/MCC Supervisor will ensure adequate team staffing, team training, participates in staff hiring and performance reviews.
December 07, 2019
Managed Care Supervisor in Lowell, MA
The individual will have a focus on assessing, interpreting, and analyzing the impact of utilization of services within the Winchester PHO to maximize performance in the managed care contracts that support the BILH Network.
February 18, 2020
Managed Care Supervisor in Montgomery, AL
The hospital offers a full range of medical services including maternity care and a Level IIB Special Care Nursery.
January 15, 2020