PRS GMC Medicare Advantage Manager

Ascension Health Alliance; United States; Remote; USD 70,000 - 110,000; Full time

Job summary

Ascension Health Alliance is seeking a Contract Manager to join Payor Contracting and Relations. The key responsibilities include negotiating payor contracts, managing financial modeling for contracting efforts, and serving as a relationship manager. This full-time position can be performed remotely and requires strong leadership and negotiation skills.

Benefits

Paid time off (PTO)

Various health insurance options

Retirement benefits with employer match

Tuition reimbursement

Qualifications

• High School diploma with 3 years experience, or Associate's/Bachelor's degree with 2 years experience.
• Experience in managed care or contracting preferred.

Responsibilities

• Manage negotiation and review of payer and employer contracts.
• Support development of value-based health opportunities.
• Monitor financial and operational performance of payer contracts.

Skills

Negotiation skills

Analytic skills

Organizational skills

Interpersonal skills

Education

High School diploma or equivalent with 3 years experience or Associate's/Bachelor's degree with 2 years experience

Tools

Google Suite

Job description

Details

• Department:Payor Contracting and Relation
• Schedule: Full-time, 8 hour day shift, Monday - Friday, Remote
• Facility: Ascension

Benefits

Paid time off (PTO)
Various health insurance options & wellness plans
Retirement benefits including employer match plans
Long-term & short-term disability
Employee assistance programs (EAP)
Parental leave & adoption assistance
Tuition reimbursement
Ways to give back to your community

Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance and salary range at the time of the offer.

Responsibilities

Manage the negotiation and review of payer and direct employer contracts for the organization.

• Support the development and contracting for value-based population health opportunities and new reimbursement models.
• Manage financial modeling specific to contracting efforts, ensuring negotiated rates meet desired objectives.
• Develop reports and reporting solutions specific to payer relations, managed care and contracting needs.
• Monitor the financial and operational performance of payer contracts.
• Provide reports and analysis of performance, providing recommendations and feedback for contract renewals, renegotiations or termination.
• Serve as a relationship manager with payers in the market.
• Monitor all aspects of the relationship to ensure appropriate communication and contract compliance and maintaining delegated payer credentialing status.

Requirements

Education:

• High School diploma equivalency with 3 years of cumulative experience OR Associate's degree/Bachelor's degree with 2 years of cumulative experience OR 7 years of applicable cumulative job specific experience required.
• 3 years of leadership or management experience preferred.

Additional Preferences

• 3-5 years of managed care or contracting, including experience with provider relations, network development, and/or contract management, preferred.
• 3-5 years of direct contract red line experience, preferred.
• 3-5 years of proven negotiation skills and the ability to build strong relations with various health-care providers, preferred.
• 3-5 years of federal and state legislative environments, regulatory processes, and government health-care programs (e.g., Medicare, Medicaid) is preferred.
• Strong experience leading and managing teams, required.
• Strong Google Suite Professional experience, required.
• Strong analytic skills a mush have
• Strong organizational skills a must have.
• Strong interpersonal skills a must have

#LI-Remote

Why Join Our Team

Ascension associates are key to our commitment of transforming healthcare and providing care to all, especially those most in need. Join us and help us drive impact through reimagining how we can deliver a people-centered healthcare experience and creating the solutions to do it. Explore career opportunities across our ministry locations and within our corporate headquarters.

Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.

Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.

Equal Employment Opportunity Employer

Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws.

For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster.

As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.

Pay Non-Discrimination Notice

Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.

E-Verify Statement

This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information.

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