Manager - Managed Care and Value Based Contracting

UC Health (Cincinnati); Cincinnati (OH); On-site; USD 110,000 - 160,000; Full time

Job summary

UC Health in Cincinnati seeks a Managed Care and Value Based Contract Manager to lead contract strategy, negotiate agreements, and oversee performance and payer relations. You will drive value-based initiatives and coordinate with stakeholders to support population health goals.

The role focuses on building a strong Managed Care team, implementing strategies to improve care quality and efficiency, and ensuring reimbursement methodologies align with value-based care objectives.

Qualifications

• Bachelor's Degree required.
• 3–5 years of equivalent experience.

Responsibilities

• Build and maintain a strong functional Managed Care team through effective training, coaching, team building and succession planning.
• Developing and implementing strategies to improve the quality and efficiency of healthcare services provided.
• Negotiating contracts and agreements with healthcare providers and payers to align incentives with value-based care goals.
• Collaborating with payers to establish and monitor performance metrics and outcomes.
• Monitoring and evaluating the effectiveness of value-based care programs and interventions; facilitating communication and coordination among different healthcare providers and settings to promote continuity of care.
• Identifying and implementing evidence-based practices and interventions to improve patient outcomes and satisfaction. Continuously seeking opportunities for innovation and improvement in the delivery of healthcare services.
• All other duties as assigned

Education

Bachelor's Degree

Job description

At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering. As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors.

UC Health is committed to providing an inclusive, equitable and diverse place of employment.

The Managed Care and Value Based Contract Manager

The Managed Care and Value Based Contract Manager is responsible for contract management including negotiation, analysis interpretation, implementation, maintenance of the contract performance, and payer relations. The position coordinates, evaluates and oversees implementation of fee for service and value-based contracting and related responsibilities, population health/clinical integration, strategies, government contracts and partnering opportunities with regional employers. The position is responsible for coordination and communication between all key stakeholders and for developing new and existing relationships with third party payers to ensure competitive agreements to ensure best possible reimbursement methodologies. This position will build and maintain a strong functional Managed Care team through effective training, coaching, team building and succession planning.

• Build and maintain a strong functional Managed Care team through effective training, coaching, team building and succession planning.
• Developing and implementing strategies to improve the quality and efficiency of healthcare services provided.
• Negotiating contracts and agreements with healthcare providers and payers to align incentives with value-based care goals.
• Collaborating with payers to establish and monitor performance metrics and outcomes.
• Monitoring and evaluating the effectiveness of value-based care programs and interventions; Facilitating communication and coordination among different healthcare providers and settings to promote continuity of care.
• Identifying and implementing evidence-based practices and interventions to improve patient outcomes and satisfaction. Continuously seeking opportunities for innovation and improvement in the delivery of healthcare services.
• All other duties as assigned

Bachelor's Degree.

3 - 5 Years equivalent experience.