Manager, Managed Care Contracting & Operations

The Manager, Managed Care Contracting & Operations is responsible for payor strategy, contracting, reimbursement, and communicating potential threats to NorthBay. The leader negotiates with healthcare insurance companies and oversees the implementation, monitoring, and evaluation of hospital, physician, and ancillary managed care payor contractual arrangements.

Requirements

• Communicate the changing landscape of payor network, pricing, consolidation and payment strategies
• Suggest strategies for mitigating financial damage to NorthBay in advance of the implementation of these strategies by payors
• Conduct Payor Contract Negotiations under oversight of leadership
• Conduct or oversee Subcontract Negotiations
• Manage or Oversee Operationalization and staff education of managed care contracts and related topics
• Manage or Oversee Data Collection and Analysis
• Oversee the management of the claim’s payment function for hospital and medical group claims
• Manage or Oversee capitation reconciliation and stop loss functions

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• Life insurance
• Disability insurance
• Long-term care coverage
• Paid time off
• Sick leave
• Holidays
• Bereavement leave
• 403(b) retirement plan
• Education reimbursement
• Professional development and training programs
• Employee Assistance Program
• Wellness programs
• Recognition programs
• Shift differentials
• Market-based compensation review and increases