Director-Managed Care Contracting Operations - REMOTE Job Listing at Mercy in Chesterfield, MO (Job ID 958813)

Description

We're a Little Different

Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service.

At Mercy, we believe in careers that match the unique gifts of unique individuals – careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its “Top 100 Places to Work.”

Overview:

This is a REMOTE position.

The Director – Managed Care Contracting Operations contributes to the organization's growth and profitability by providing operational expertise to existing and potential physician practices; and serves in a leadership role, providing subject matter expertise, guidance, and direction to practice management consultants.

Performs duties and responsibilities in a manner consistent with our mission, values, and Mercy Service Standards.

• Recommend, develop, and implement programs, services, and strategies related to Mercy Ministry Strategic Integration Goals.
• In coordination with and as assigned by Population Health and Contract Revenue and Managed Care Leadership, interface with various Mercy internal departments, i.e., Business Office, Legal, Mercy Clinic, Hospital Administration, Strategic Finance, etc., to address operations issues and oversee the coordination of implementing efficient processes in response to operations concerns and/or enhancement.
• Oversee key Ministry level projects directly affecting Managed care and indirectly affecting other ministry departments and performance divisions.
• Oversee Ministry-wide support staff and provide guidance and direction for processes including:
• Maintaining various SharePoint, Teams and data.
• Oversee teams responsible for disseminating relevant contract details to key departments (Finance, Business Office, Patient Access, UM, etc.) upon execution of a new contract or contract renewal. Assist such department with any necessary socializing of contract provisions.
• Oversight of Contracting lifecycle maintenance.
• Be knowledgeable regarding key payor contractual provisions related to claims processing and payment terms and condition.
• Responsible for payer contract integrity including policy and contract provision adherence and review
• Support all price transparency efforts and initiatives.
• Oversee supplemental managed care contracting support including, but not limited to single case agreement and settlement support.
• Provides oversight and support to payer issues and escalations meetings as needed
• Develop and maintain appropriate relations with managed care payors.
• In coordination with Managed Care Contracting leaders, oversee growth and acquisition (clinic and HOD) projects and initiatives.

Qualifications:

• Experience: Requires minimum of 5 years previous experience in areas of managed care or healthcare operations. Previous supervisory experience required.
• Required Education: Requires Bachelor's Degree in Business Administration filed, Health Care, or equivalent experience in lieu of a degree. In lieu of degree, 9 years previous experience in areas of managed care or healthcare operations.
• Other: Must have strong communication, organizational, and analytical skills. Must have familiarity with use of various software packages, such as MS Office, etc. Must have a proven ability to lead, persuade, influence and negotiate with respect to Managed Care contracting initiatives, as well as within Operations Department and among other support departments; have a proven ability to understand and foresee corporate implications of subtle detail changes; have a proven ability to identify and implement cross-functional process improvements; be detail-oriented and well-organized; have proven ability to track issues and follow through on resolution; have ability to read, analyze, interpret and use complex business documents, contracts, regulations, policies and procedures; and have strong verbal and written communication and interpersonal skills. Communication and interpersonal skills must include demonstrated ability to communicate effectively and tactfully to internal and external contacts and physicians to present and obtain sensitive information. Must have the ability to exercise sound business judgment within general company policies. Must possess highly-effective time management and organizational skills to independently manage team to achieve multiple objectives according to high quality standards. Must be able to work effectively within a team environment.

We Offer Great Benefits:

Day-one comprehensive health, vision and dental coverage, PTO, tuition reimbursement and employer-matched retirement funds are just a few of the great benefits offered to eligible co-workers, including those working 32 hours or more per pay period!

We're bringing to life a healing ministry through compassionate care.

At Mercy, our supportive community will be behind you every step of your day, especially the tough ones. You will have opportunities to pioneer new models of care and transform the health care experience through advanced technology and innovative procedures. We're expanding to help our communities grow. Join us and be a part of it all.

What Makes You a Good Match for Mercy?

Compassion and professionalism go hand-in-hand with us. Having a positive outlook and a strong sense of advocacy is in perfect step with our mission and vision. We're also collaborative and unafraid to do a little extra to deliver excellent care – that's just part of our commitment. If that sounds like a good fit for you, we encourage you to apply.

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