Keystone Advisors · 4 hours ago
Manager of Managed Care Operations
Chicago, IL
Full-time
Onsite
Senior Level
5+ years expKeystone Advisors LLC is looking for a Manager of Managed Care Operations to support one of their healthcare clients in the Illinois Medical District in the West Loop of Chicago. The role involves collaborating with managed care plans and internal hospital departments to implement strategies that enhance the financial success of managed care contracts.
Health CareHealth InsuranceInsuranceProfessional Services
Responsibilities
Assists the Managed Care Director with negotiations, for both fees for service & value-based care agreements through the use of financial analysis and contract language reviews
Maintains relationships with Payers and works to resolve contract compliance issues by working closely with revenue cycle leadership, to ensure revenue streams are not disrupted
Assists the Managed Care Director with the oversight of contracted managed payers
Develop and oversee the implementation of strategies to improve managed care performance in terms of utilization, patient access, cost, compliance with contractual quality measures, etc. Align improvement with quality and financial goals
Contribute to the management of department staff and employees’ systemic development and success
Discuss and develop system policies and procedures
Consistently use independent judgment to identify operational staffing issues and needs and perform the following functions as necessary; hire, transfer, suspend, layoff, recall, promote, discharge, assign, direct or discipline employees pursuant to applicable policies
Other duties as assigned
Qualification
Required
Must understand healthcare contracting including financial analysis, credentialing, legal review, Value Based Care, and utilization data
Effective communication skills both written and verbal as well as the ability to exercise judgement when working with individuals with different points of view on a critical issue
Excellent presentation and negotiation skills
Ability to maintain confidentiality of all patient information, per HIPAA requirements
Knowledge and high level of proficiency in Microsoft Office software suite
Strong interpersonal and leadership skills to lead and direct the Managed Care department
Bachelor's degree from an accredited university
Five (5) years of managed care work experience within a health system, managed care organization, or consulting firm
Strong leadership and negotiation skills. Knowledge of managed care contracting rates for network providers, services, and facilities
Advanced ability to operate computers and related software for Microsoft programs including Word, Excel, Outlook
Sound financial acumen and the ability to analyze and interpret financial reports and metrics
Proven ability to build and maintain strong relationships with vendors and internal stakeholders
Preferred
Master's degree in business administration, health administration or finance from an accredited college or university
Benefits
Paid Time Off
Health, Vision & Dental Insurance
Health Savings Account (HSA)
Flexible Spending Account (FSA)
Short & Long Term Disability
401(K)
Life Insurance
Company
Keystone Advisors
At Keystone Advisors, we believe that progress starts with change.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Michael Rodriguez
Chief Operating Officer
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