Manager - Managed Care and Value Based Contracting

UC Health; Cincinnati (OH); On-site; USD 90,000 - 130,000; Full time

Job summary

UC Health in Cincinnati, OH, is seeking a Managed Care and Value Based Contract Manager to oversee contract negotiation, analysis, implementation, and payer relations. This role coordinates fee-for-service and value-based contracts and collaborates with regional employers to ensure optimal reimbursement methodologies.

The position requires a Bachelor's degree and 3–5 years of equivalent experience in managed care, with a focus on population health and clinical integration.

Qualifications

• Bachelor's degree required.
• 3–5 years of equivalent experience in healthcare contracting or managed care.

Responsibilities

• Build and lead a Managed Care team through training and development.
• Develop strategies to improve quality and efficiency of healthcare services.
• Negotiate contracts with providers and payers to align incentives with value-based care.
• Collaborate with payers to establish performance metrics and monitor outcomes.
• Monitor effectiveness of value-based care programs and facilitate coordination across providers.

Skills

Contract management

Payer relations

Strategic negotiation

Education

Bachelor's Degree

Job description

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 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.

Location

Cincinnati, OH, United States

Qualifications

• Bachelor's Degree.
• 3 - 5 Years 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