Manager Managed Care Payer Relations

UNC Health; Morrisville (NC); On-site; USD 90,000 - 135,000; Full time

Job summary

UNC Health in Morrisville, NC is seeking a Managed Care Payer Relations Manager to oversee day-to-day payer relations activities, develop and sustain relationships with managed care payers, and provide information about network procedures or contracts. The role also reviews billings and claims payments under managed care contracts.

The position is full-time in a hybrid work setting, with location in US:NC:Morrisville and responsibilities that include leading people and ensuring contract

Qualifications

• Bachelor’s degree in relevant field.
• Requires five (5) years of experience with managed care contracts and provider relations. If Associate’s degree, requires nine (9) years of experience with managed care contracts and provider relations.

Responsibilities

• Payer Relations- Manages relationships and represents UNC Health as a primary point of contact and liaison in various managed care contractual relationships, handling communication, contract compliance, problem resolution, legal issues, etc.

Education

Bachelor’s degree in relevant field

Job description

Description

Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina.

Summary:
The Managed Care Payer Relations Manager manages the day- to- day activities of the payer relations function. Develops, manages, and sustains relationship with managed care payers. Serves as a resource, answering questions and providing information about network procedures or contracts. Reviews billings and claims payments according to managed care contracts.

Responsibilities

• 1. Payer Relations- Manages relationships and represents UNC HCS as a primary point of contact and liaison in various managed care contractual relationships, handling communication, contract compliance, problem resolution, legal issues, etc.
• 2. Managed Care Analysis- Identifies management information needs; researches and analyzes data to provide necessary information to leadership positions. Analyzes financial, contractual, and operational issues related to contracted payers. Reports to Health Care System leadership the financial impact of billing and claims payment issues according to managed care contracts. Verifies the accurate and on-time loading of professional fee schedules by payers and in the UNC HCS Contract Manager tool.
• 3. Leading People- Leads people toward meeting the organization's vision, mission, and goals. Provides an inclusive workplace that fosters the development of others, facilitates cooperation and teamwork, and supports constructive resolution of conflicts. Treats sensitive or confidential information appropriately. Works to improve and reinforce performance of others. Delegates assignments, clarifies expectations and holds others accountable for achieving results related to their area of responsibility. Encourages workforce engagement by building a commitment to excellence. Works collaboratively toward solutions that accomplish organizational objectives.

Other Information

Education Requirements:

• Bachelor’s degree in relevant field

Licensure/Certification Requirements:

Professional Experience Requirements:

• Requires five (5) years of experience with managed care contracts and provider relations. If Associate’s degree, requires nine (9) years of experience with managed care contracts and provider relations.

Knowledge/Skills/and Abilities Requirements:

Job Details

Legal Employer: NC Health

Entity: Shared Services

Organization Unit: Managed Care

Work Type: Full Time

Standard Hours Per Week: 40.00

Salary Range: Pay offers are determined by experience and internal equity

Work Assignment Type: Hybrid

Work Schedule: Day Job

Location of Job: US:NC:Morrisville

Exempt From Overtime: Exempt: Yes

This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully‑owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job.

Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.

UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email [e-mail] if you need a reasonable accommodation to search and/or to apply for a career opportunity.