Manager of Manager Care Contracting

 
Position: Manager of Manager Care Contracting

Job ID: 152482

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, the first hospital devoted to children’s care for communities north of Houston. 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 Manager of Managed Care Contracting – someone who works well in a fast-paced setting. In this position, you will provided oversight and supervision to the Managed Care Contracting staff responsible for the development and maintenance of managed care contracts for the various entities owned and operated by the Integrated Delivery System, and continually develop management programs in response to analysis and research of managed care trends and benchmarks as well as the strategic goals of our client, our client’s PSO, Pediatrics, Urgent Care, and the Integrated Delivery System. Additionally, you will support and develop staff through equitable distribution of resources and assignments, education, and implementation of processes and procedures that provide and maintain a cost-effective provider contracting unit that maximizes reimbursement to all entities including but not limited to our client’s PSO, Pediatrics, and Urgent Care.

 

Think you’ve got what it takes?



Responsibilities :

  • Provides development and supervision of managers and staff
  • Participates in interdepartmental groups to represent managed care contracting needs including claims, medical management, operations, finance quality improvement, and/or other related services
  • Interfaces with internal and external staff to resolve contract performance issues and complaints in a timely manner
  • Routinely assesses productivity and accuracy of staff work
  • Serves as a liaison with community agencies and other groups and organizations which can impact and/or influence payer contract strategies
  • Responsible for provision of necessary resources to meet review requirements of State, Federal and/or accrediting standards as it relates to managed care contracts
  • Provides analysis of reports as required
  • Maintains current knowledge and contacts with alternate sites for appropriate healthcare delivery within the community and the state needed for pediatric and OB/GYN population
  • Conducts cost/benefit analysis functions as indicated or evaluation of different care settings and levels and provides documentation and authorizations in appropriate systems


Qualifications:

  • Bachelor’s degree in business, healthcare administration, public health, or related field required
  • 4 years’ related work experience can be substituted for a bachelor’s degree
  • 5 years’ managed care experience in a managed care organization required


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