Managed Care Contract Manager

Lincoln Surgical Hospital/Nebraska Surgery Center; Lincoln (NE); On-site; USD 70,000 - 110,000; Full time

Benefits offered by this job

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Paid Time Off (PTO)

Tuition Reimbursement

Flexible Spending Accounts (FSA)

401(k) with Company Match

Short-Term and Long-Term Disability

24/7 Wellness Center Access

Job summary

Lincoln Surgical Hospital in Lincoln, NE seeks a Managed Care Contract Manager to provide strategic leadership and financial oversight for managed care contracting with commercial payers. You will grow contracted business, negotiate reimbursement rates, and align payer partnerships with the organizations' financial goals.

The role requires rigorous contract analysis, strong negotiation skills, and expertise in CPT/ICD/DRG methods.

Qualifications

• Bachelor's degree in Accounting, Finance, Business Administration, or a related field is required.
• Experience with payer contract negotiation is preferred.
• Equivalent combination of education, training, and experience may be considered.

Responsibilities

• Conduct comprehensive contract and reimbursement analyses.
• Evaluate payer agreements and rate structures.
• Develop innovative partnership and reimbursement models.
• Identify contracting opportunities and lead contract negotiations.
• Monitor contract performance and financial modeling.
• Manage payer relationships and respond to market changes.

Skills

Negotiation strategies

Healthcare insurance

Billing & reimbursement

CPT/ICD/DRG classifications

Analytical thinking

Excel & reporting tools

Healthcare administration

Education

Bachelor's degree in Accounting, Finance, Business Administration, or related field

Tools

Microsoft Excel

Database analysis tools

Reporting tools

Job description

Job Details

Job Location: Lincoln Surgical Hospital - Lincoln, NE 68506, The Managed Care Contract Manager provides strategic leadership and financial oversight for managed care contracting with commercial payers on behalf of Lincoln Surgical Hospital, Nebraska Surgery Center, and NOC Surgery Center. This role is responsible for maintaining and growing contracted business relationships while negotiating reimbursement rates that support the organizations' financial goals and long-term success.

Key Responsibilities

Key responsibilities include conducting comprehensive contract and reimbursement analyses, evaluating existing payer agreements and rate structures, developing innovative partnership and reimbursement models, identifying contracting opportunities, leading contract negotiations, monitoring contract performance, performing financial modeling, managing payer relationships, and responding effectively to evolving healthcare insurance products and market changes.

Schedule

Full-Time | 80 Hours per Pay Period (2 Weeks)

Monday - Friday

Education & Experience

• Bachelor's degree in Accounting, Finance, Business Administration, or a related field required.
• Experience with payer contract negotiation preferred.
• An equivalent combination of education, training, and experience may be considered.

Qualifications, Skills & Abilities

• Demonstrated knowledge of negotiation strategies and techniques with the ability to effectively advocate for organizational interests.
• Strong understanding of healthcare insurance, hospital and ambulatory surgery center (ASC) billing and reimbursement processes, healthcare administration, and related industry practices.
• Familiarity with coding and reimbursement methodologies, including CPT, ICD, DRG classifications, Medicare reimbursement models, and quality initiatives.
• Excellent analytical and problem-solving skills.
• Proficiency in Microsoft Excel, database analysis, reporting tools, and other business applications.

Benefits

• Health Insurance
• Dental Insurance
• Vision Insurance
• Life Insurance
• Paid Time Off (PTO)
• Tuition Reimbursement
• Flexible Spending Accounts (FSA)
• 401(k) with Company Match
• Short-Term and Long-Term Disability Insurance
• 24/7 Wellness Center Access