Director Of Managed Care Contracting

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Director of Managed Care Contracting -
Duties: Development of new and existing relationships with managed care organizations and third party payers to ensure competitive reimbursement rates and contract language attainable through the revenue cycle operations. This area of responsibility is expected to expand significantly as SBM continues to develop its regional provider affiliation activities. Oversight of Delegated Credentialing Agreements. Work with various department leaders throughout SBM to monitor the performance of new and existing managed care agreements and intercede with managed care organizations and third party payers to address operational problems and contract performance deficiencies. Address deficiencies in compliance and payment by managed care organizations or third party payers which routinely result in significant lost revenue. If not promptly resolved, work with managed care organization or third party payers legal counsel in developing new legal and litigation initiatives to address the payer that is in breach of agreements. Associated revenue related duties include supporting Purchasing and Procurement in their contracting activities and acting as consultant to SBM’s Long Stay Discharge Committee.

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