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)
At Johns Hopkins All Children's Hospital we offer an excellent Benefits Package, to include:
Managed Care Analyst Position Summary:
The Managed Care Analyst is responsible for all loading, modeling, support, and maintenance of the managed care contracts and fee schedules within the contract management system. This includes contracts for all Health Systems entities; facility, professional, home care, infusion, pharmacy, etc. Provides key support for the implentation of new and upgraded systems/releases or new/revised operational procedures. Is capability to model, support and operationalize risk-based contracting methodologies and global transplant agreements is also necessary.
Managed Care Analyst Key Accountabilities:
Work Hours: 8am - 4:40pm
Work Location: Remote
(must reside in Maryland, Virginia, Washington DC, Pennsylvania, Florida or Delaware)
Managed Care Analyst Qualifications:
We are committed to providing a healthy and safe environment for our patients, visitors and staff members. The Johns Hopkins Hospital has a tobacco-free at work policy. Employees must refrain from using any tobacco products during their work shifts — including while at lunch or on breaks, and whether they are on or off campus.
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