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Mgr HP Contracting & Service - GA

Role overview

Qualifications

  • Bachelor’s Degree in Business Administration or related field
  • Minimum of three (3) years of progressive experience in health care or managed care
  • Experience in provider relations or contracting
  • Previous management experience preferred

Responsibilities

  • Manage and negotiate assigned contracts and conduct financial impact analysis
  • Track and report on contracting trends and departmental goals
  • Develop and report key accomplishments and issues to upper management
  • Manage day to day operations of direct reports, including hiring and staff development

Key facts

  • Remote from: Georgia (USA)
  • Full time
  • Mid-level (2-5 years)
  • English

Other skills

  • Strategic Planning
  • Microsoft Office
  • Relationship Management
  • Communication
  • Social Skills
  • Problem Solving
  • Critical Thinking
  • Detail Oriented
  • Leadership

About the company

CareSource logo

CareSource

Health Insurance (Payers)

Health Care with Heart. It is more than a tagline; it’s how we do business. CareSource has been providing life-changing health care to people and communities for nearly 30 years and we will continue to be a transformative force in the industry by placing people over profits. CareSource is and will always be members first. Even as we grow, we remember the reason we are here – to make a difference in our members’ lives by improving their health and well-being. Today, CareSource offers a lifetime of health coverage to nearly 2 million members through plan offerings including Marketplace, Medicare Advantage and Medicaid. With our team of 4,000 employees located across the country, we continue to clear a path to better life for our members. Visit the "Life" section to see how we are living our mission in the states we serve. CareSource is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, age, national origin, disability, sexual orientation, gender identity, genetic information, protected veteran status or any other characteristic protected by applicable federal, state or local law. If you’d like more information about your EEO rights as an applicant under the law, please click here: https://www.eeoc.gov/employers/upload/poster_screen_reader_optimized.pdf and here: https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf Si usted o alguien a quien ayuda tienen preguntas sobre CareSource, tiene derecho a recibir esta información y ayuda en su propio idioma sin costo. Para hablar con un intérprete, Por favor, llame al número de Servicios para Afiliados que figura en su tarjeta de identificación. 如果您或者您在帮助的人对 CareSource 存有疑问,您有权 免费获得以您的语言提供的帮助和信息。 如果您需要与一 位翻译交谈,请拨打您的会员 ID 卡上的会员服务电话号码。

Company details

Company typeLarge
IndustryHealth Insurance (Payers)
Company size1001 - 5000

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Job description

Job Summary:

The Manager, Market Contracting is responsible for assisting the Director, and managing a team, to manage and negotiate assigned contracts including analysis of the contract proposals and conducting financial impact to make informed decisions as well as support activities related to quality and affordability initiatives (QAIs).

Essential Functions:

  • Responsible for tracking and trending, contracting trends, inventory, and priorities
  • Assists with the development and evolution of the team’s strategic direction, annual goals, and objectives; recommends new processes and changes for increased department productivity to ensure appropriate network adequacy and access across all products
  • Establish and maintain strong working relationships with key internal and external business partners
  • Develop and report on key accomplishments and issues to upper management
  • Lead cross-functional workgroups for special priority contracts, create and manage work plans, and facilitate the removal of barriers to ensure timely implementation of key contracts and providers
  • Conduct project team meetings to establish and execute on detailed project plans
  • Report on key initiatives and accomplishments to leadership, including PowerPoint report outs
  • Ensure proper documentation and standard operating procedures (SOPs) are followed by staff
  • Implement and maintain key metrics for staff performance
  • Manage day to day operations of direct reports, to include hiring decisions, performance management, training, and staff development
  • Participate in network provider meetings, attend key committees, subcommittees, and/or workgroups as necessary
  • Manage multiple projects; collect and analyze data and disseminate to appropriate departments as necessary
  • Ensure appropriate documentation of interactions and projects by all team members
  • Coordinate contract language change requests to ensure template accuracy and utilization
  • Perform any other job duties as requested

Education and Experience:

  • Bachelor’s Degree in Business Administration or related field, or equivalent years of relevant work experience is required, or combination of education and related work experience
  • A minimum of three (3) years of progressive experience in health care or managed care is required
  • Experience in provider relations or contracting is required
  • Previous management experience is preferred

Competencies, Knowledge and Skills:

  • Proficient with Microsoft Office to include Word, Excel and PowerPoint
  • Excellent written and verbal communications skills
  • Ability to develop, prioritize and accomplish goals
  • Detail oriented
  • Strong interpersonal skills and high level of professionalism
  • Effective listening and critical thinking skills
  • Effective problem-solving skills with attention to detail
  • Ability to work independently and within a team
  • Strong negotiation skills
  • Excellent leadership skills
  • Ability to create and maintain excellent working relationships
  • Excellent research and analytical skills
  • Business Analysis skills

Licensure and Certification:

  • Valid driver’s license is required; employment in this position is conditional pending successful clearance of a driver’s license record check.  If the driver’s license record results are unacceptable, the offer will be withdrawn or, if you have started employment in this position, your employment in this position will be terminated
  • To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
  • CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.

Working Conditions:

  • General office environment; may be required to sit or stand for extended periods of time

Compensation Range:

$83,000.00 - $132,800.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

  • Fostering a Collaborative Workplace Culture

  • Cultivate Partnerships

  • Develop Self and Others

  • Drive Execution

  • Influence Others

  • Pursue Personal Excellence

  • Understand the Business


 

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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