Managed Care Contractor

About the role

Responsible for providing analysis and support during contracting process; supplying reimbursement reports and analyses; ensuring optimization of net revenue under existing managed care contracts; and acting as consultant to BJC HSO's on managed care issues.

This position is responsible for negotiating managed care contracts in coordination with patient accounts medical case management on behalf of SLHS 10 hospitals home health agencies and over 400 employed physicians. In addition this position is responsible for developing and maintaining ongoing relationships with managed care plans conducting monthly operations meetings and working through the implementation and ongoing administration of managed care contracts

Coordinate financial support and analysis for managed care contract negotiations.

Analyzes pricing and financial trends to develop strategic initiatives.

Develops and utilizes innovative reporting tools.

Reviews and acts as a consultant to reimbursement methodologies and rate development.

Applicable Experience: