الصفحة الرئيسية الإمارات العربية المتحدة Care Manager
الصفحة الرئيسية الإمارات العربية المتحدة Care Manager
Care Manager
تفاصيل الوظيفة
Position Summary Under the direction of the Operations Director and Executive Director, this position is responsible for the negotiation, optimization, and operational management of the managed care contracts; Medi-Cal, Medicare, Commercial, PPO, FFS, etc. Schedule:
- Flexible, may require some evening and weekends
- Hours worked per week may exceed 40 hours
- Directs negotiation of managed care contracts including optimal capitation rates, fee-for-service reimbursements, bonuses, incentives, etc.
- Reviews, negotiates, and renegotiates payor contracts including rates and contract language provisions.
- Develops and maintains a complete library of payor contract documentation for each payor including contract summary documents, copies of all fully-executed contracts with related amendments, letters, policies, and other operational reference materials.
- Initiates, fosters, and maintains productive long-term relationships with key payor contacts.
- Collaborates with other departments to generate quantitative and qualitative data analyses to support negotiations.
- Interfaces with other divisional managers to ensure operational efficiencies and effective administration of all contractual agreements.
- Interfaces with internal departments to ensure the completion and submission of contractual documentation to contracted health plans or IPAs (i.e., provider roster, credentialing information).
- Ensures capture of incentives based on services provided: 120-day health assessments, timely encounter data submission, HEDIS, CHDP services, etc.
- Negotiates contractual agreements with IPAs and health plans on specialty services such as OB, Mental Health, CPSP, DM Program, etc. based on fee-for-service model and health care outcomes.
- Able to create and analyze productivity and financial reports, make appropriate recommendations, and corrective action plans.
- Assists Operations Director in developing the IPA Network with other community clinics.
- Partners with Operations Director to ensure compliance as required by Health Plans, IPAs, and other regulatory agencies.
- Participates in organizational meetings as requested.
- Performs other duties as assigned.
- Proficiency in Microsoft Office applications (Word, Excel, PowerPoint, Access, Outlook)
- Strong interpersonal and communication skills
- Ability to interface with all levels of management
- Effective prioritization, multi-tasking, and follow-up skills
- Strong attention to detail
- Ability to work as a team player and independently
- Reliable transportation
- Must be able to travel from facility to facility
- This position requires 10% travel with frequent travel outside the local area.
- Knowledgeable of Managed Care and IPA business models
- Minimum of 5 years’ experience in Managed Care with contract negotiations experience
- Bachelor’s Degree in Finance/Accounting, Business Administration, Public Health, or other related studies strongly preferred and/or equivalent work experience
- Strong Accounting and Financial background
- Knowledgeable of Medi-Cal Managed Care and Medicare compliance, HMOs, and other regulatory agency guidelines
- Commitment to goals and philosophy of Northeast Community Clinic
- Valid State Identification
Apply safely
To stay safe in your job search, information on common scams and to get free expert advice, we recommend that you visit SAFERjobs, a non-profit, joint industry and law enforcement organization working to combat job scams.
الشركة المعلنة عن الوظيفة
ClickJobs.io
-
Managing & Improving Customer Service Process Certificate New Skills Academy88 درهم
1,098 درهممدة الدورة التدريبية: Upto 8 Hours -
Customer Service Skills John Academy90 درهم
918 درهممدة الدورة التدريبية: 2 Hours
Similiar Jobs that might interest you
Manager - EIT & Integration Engineering
NES FircroftManager - EIT & Integration Engineering Job objectives: Responsible for Basic, Detail engineering and follow up on ...
UAE - Dubai 21 أيام مضت
Talent Management Lead
Halliburton... an undergraduate degree in Human Resources Management, Business Administration, or a similar ...
UAE - Abu Dhabi 21 أيام مضت
HR Manager
NES... in UAE. Position: HR Manager Job Profile: 10 + years ... our clients with the engineering and technical expertise they ...
UAE - Dubai 21 أيام مضت
Senior, Reservoir Management Engineer
International Development Company Manpower Supply... in integrating ... Management skills/ Water flooding • Bachelor's Degree in Sciences (Petroleum/ Reservoir Engineering ...
UAE - Abu Dhabi 21 أيام مضت
Senior, Reservoir Management Engineer
International Development Company Manpower Supply... in integrating ... Management skills/ Water flooding • Bachelor's Degree in Sciences (Petroleum/ Reservoir Engineering ...
UAE - Abu Dhabi 21 أيام مضت
Engineering Manager
NES Fircroft... its client for an • ENGINEERING MANAGER • in UAE with at ... our clients with the engineering and technical expertise they ...
UAE - Abu Dhabi 21 أيام مضت
Mechanical Completion Manager
NES Fircroft... . Position -Mechanical Completion Manager Location: Dubai UAE. ... clients with the engineering and technical expertise ...
UAE - Dubai 21 أيام مضت
Contract Manager
NES... company. Contract Management, Variation order management, Contract/ Legal ... clients with the engineering and technical ...
UAE - Dubai 21 أيام مضت
Rope Access Project Manager
Oceaneering... global provider of engineered services and products, ... diligence regarding the Integrated Management Systems on the ...
UAE - Abu Dhabi 21 أيام مضت
Construction Supervisor Flange Management
NES Fircroft... Management Location: Dubai UAE. Key responsibilities Flange management ... delivery with FFA engineering and procurement ...
UAE - Dubai 21 أيام مضت
Well Integrity Engineer (Petroleum
Confidential... Integrity Engineer (Petroleum) BSc. Petroleum Engineering, preferably MSc. Petroleum Engineering ... Integrity Management. ...
الإمارات العربية المتحدة 21 أيام مضت
Senior Project Controls Engineer
NES Fircroft... Position: Senior Project Controls Engineer Duration: 6 months ... with project management, system administration ...
UAE - Abu Dhabi 21 أيام مضت
Rope Access NDT Technician
Oceaneering... diligence regarding the Integrated Management Systems on the ... (E) • Degree in Engineering (or equivalent) • Offshore ...
UAE - Dubai 21 أيام مضت
Payable Accountant
NES Fircroft... Non-managed vendor setup: Creating a new non-managed vendor ... our clients with the engineering and technical expertise ...
UAE - Abu Dhabi 21 أيام مضت
Testpack Coordinator
NES Fircroft... /Professional Degree in Engineering, or equivalent extensive ... Proven track record of managing large-scale projects ...
UAE - Dubai 21 أيام مضت
... material delivery with FFA engineering and procurement groups o ... disciplines o Advise Construction Manager about lack of ...
UAE - Dubai 21 أيام مضت
PLC Automation Engineer
NES Fircroft... Role: OT Cyber Security Engineer Location: Dubai Contract Duration ... Shedding, sharing and management. IEC 61850, IEC ...
UAE - Dubai 21 أيام مضت
... managing projects from FEED through detailed engineering, construction, commissioning and handover. Project management ...
UAE - Dubai 21 أيام مضت
NDT Technician (Fixed Term - 12 Months)
Oceaneering... performance or integrity. Use ... by management Qualifications REQUIRED ... • Degree in Engineering (or equivalent) • ...
UAE - Dubai 21 أيام مضت
لماذا تقوم بالإبلاغ عن هذه الوظيفة؟
Job has expired لا يمكن عرض هذه الصفحةبدلًا من ذلك، يمكنك النقر على الرابط أدناه أو نسخ/لصق الرابط في متصفح الإنترنت الخاص بك.
https://ae.jooble.org/external/-2481558864894873432?cpc=d0FU&utm_source=affiliate&utm_medium=laimoon_organic_ae&extra_ars_request_id=c20b54561512e129559285617bb62a74