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)
Summary:The Senior Contract Manager, Contract Manager is responsible for the implementation and facilitation of managed care contracts, contract compliance, and related activities for CharterCARE Health Partner System under the direction of the Senior Director, Managed Care Operations and Payer Relation.
Education: Bachelor’s degree in health care administration or related field; Master’s Degree preferred.
Experience: A minimum of 7 years’ of managed care contracting for multi-hospital system and or health plan(s) and reimbursement analysis in either a provider or payer setting required. Experience with risk and value-based arrangements.
Skills and Abilities:
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