Managed Care Contracts Administrator

 
Position: Managed Care Contracts Administrator

Job ID: 148535

Location: US-TX-Houston

Department: PAYER CONTRACTING & RELATIONS

Talent Area: Professional - Non-Clinical

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8a - 5p

About Texas Children's Hospital

Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S.News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years.

Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Center for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; and Texas Children’s Hospital The Woodlands, a second community hospital opening in 2017. We have also created the nation’s first HMO for children, established the largest pediatric primary care network in the country and a global health program that is channeling care to children and women all over the world. Texas Children’s Hospital is also academically affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation.

To join our community of 13,000 dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.



Summary:

We are searching for a Managed Care Contract Administrator— someone who works well in a fast-paced setting. In this position, you’ll support the Managed Care Contracting team in the development, negotiation, implementation, monitoring, and management of agreements. The role assists in the research of managed care trends while accurately communicating any terms that may impact reimbursement to the appropriate departments. You’ll assist in reviewing and analyzing routine variance reports to accurately determine if contracts are performing in accordance with terms.

 

Think you’ve got what it takes?



Responsibilities :

  • Negotiates high volume, hospital and physician group contracts
  • Reviews, analyzes, and reports single case agreements to monitor the performance of executed agreements on a quarterly basis or more often when required or requested to do so
  • Reviews each assigned hospital and physician group contract at least annually, prior to renewal or anniversary, to determine which contracts should be renewed or renegotiated and reports results to management
  • Develops and maintains strategic relationships with IDS personnel and health plans at all levels of authority
  • Provides internal education regarding contract updates, health plan policy to all internal stakeholders as needed
  • Works with Senior Managed Care Contracts Administrator to learn about state and federal requirements relating to various health plan products and designs, including, but not limited to, Medicaid Managed Care, SCHIP, commercial Managed Care, CMS Medicare rates and rules, and third-party administrators
  • Implements new health plan contracts
  • Supports management through communication, ad hoc reporting, and quality improvement initiatives


Qualifications:

  • H.S. Diploma or GED
  • 5 years of hospital managed-care experience, facility contracting, provider relations, or hospital business office role
  • A Bachelor’s degree will substitute four (4) years of work experience, a master’s degree will substitute for two (2) years of work experience


Apply Now
Current Texas Children’s employees – Please click here to login.
Create Profile or Log In Search Careers