Regional Manager Health Plan Contracting in Plano, TX at Prime Healthcare

Date Posted: 1/6/2021

Job Snapshot

  • Employee Type:
  • Location:
    6652 Pinecrest Drive
    Plano, TX
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:

Job Description

Overview •May be based in Florida*

Responsibilities Regional Manager, Health Plan Contracting is responsible for the management and data integrity of the managed care agreements for Prime Healthcare in a multi-state environment for assigned region hospitals. The Regional Manager effectively interacts with Corporate Executive Management, Hospitals and Business Office Management and commercial, Medicare Advantage, Medicaid Managed Care and other third-party payers. The Regional Manager will work on contract negotiations (language and rates); manage ongoing payer relationships; monitor regulatory, provider manual, and related process changes; assist in the measurement of payer compliance with contract terms; participate in JOCs; and assist hospital and business office management in resolution of issues related to managed care agreements. #LI-CC1

Required qualifications:

    Bachelor of Business/health/management field or relevant Bachelor’s Degree.Analytical skills with emphasis on contract development, assessment and negotiation, financial analysis problem solving and project/time management.Five (5) years of contract negotiation/managed care experience in a hospital or hospital system setting.Must obtain Sexual Harassment Certification within 6 months, and then maintain biennially.
Preferred qualifications:

    Business office and claims knowledge and/or experience
We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources. EEO is the Law: