Manager of Managed Care Contract

Job Requisition #: JR57816

End Date: 9/27/2021

Location: Wilmington, Delaware

Position Type: Professional

Shift: Day Shift, No Rotation

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When you become an employee at ChristianaCare, you are joining a healthcare organization that was named Forbes 5th Best Health System to Work for in the U.S. for 2021! Guided by excellence and love, our Caregivers enjoy many employee benefits such as

  • work-life balance
  • competitive pay and benefits
  • generous paid time off
  • diverse and inclusive culture

ChristianaCare is seeking a Manager of Managed Care Contracting to conduct and coordinate the day-to-day contracting activities of the Managed Care Contracting Department. Reporting to the VP Enterprise Contracting & Payor Relations, this position's responsibilities include maximizing revenue by developing and negotiating significant contracts with third-party payors, primarily Managed Care Organizations (Blue Cross and Blue Shield, Aetna, United, etc.) in accordance with CCHS policies.

The Manager of Managed Care Contracting will work closely with key stakeholders across the organization in the maintenance and expansion of traditional reimbursement models which may require expanded operational capabilities, reporting infrastructure, and modeling.

A secondary function is to provide oversight and supervision of the business process of contracts processed through the legal department. This position will manage and supervise the staff associate responsible for processing contracts in accordance with the Corporate Integrity Agreement and CCHS policies and procedures.

Principal duties and responsibilities:

Negotiates and renegotiates traditional reimbursement contractual agreements with third-party payors, including single-case agreements with non-contracted payors and services.

Monitors and evaluates the performance of the managed care contracts to ensure accurate and proper payment schedules

Finds opportunities and provides recommendations pertaining to profitability and operational issues of third-party agreements.

Develops and maintains good working relationships with major third-party payors and CCHS senior administrative and clinical leadership.

Acts as a liaison and provide operational and interpretational guidance to CCHS departments (e.g. Revenue Cycle, Utilization Management, ect.) pertaining to third-party contracts.

Collaborate with partners across the organization including, but not limited to, finance, legal, population health management, clinical operations, and others to refine ChristianaCare's approach to value-based care, identify capability gaps, and make recommendations on approaches to successfully operationalize these programs.

Support our business development teams in developing value-based care relationships through direct to employer relationships.

Assist with the development of Centers of Excellence relationships across payors.

Be adaptive and able to perform multiple roles - leader, consultant, advisor - depending upon the project.

Education and experience requirements:

  • Bachelor's degree in Business Administration, Healthcare Administration or Finance from an accredited university
  • At least five (5) years of provider-based reimbursement experience, through managed care contracting, reimbursement, consulting, or population health management is required.
  • Understanding of provider contracting and various reimbursement methodologies is required.
  • Five to eight years significant hospital financial management experience with emphasis on financial analysis
  • Experience with third-party negotiations
  • Familiarity with Hospital revenue cycle

EEO Statement: Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.


UPDATE: ChristianaCare is committed to prioritizing the health and safety of our patients and caregivers. As we continue to meet the needs of our caregivers and our community through the COVID-19 pandemic, our commitment to health and safety requires that we take new steps to ensure a safe environment for medical care for our patients and a workplace that avoids preventable harm for our caregivers. For this reason, vaccination for COVID-19 is required for all caregivers at ChristianaCare and is considered a safety standard that is job-related and consistent with business necessity for all caregivers.

Why do WE offer careers full of possibilities?

For the Love of Health.

Inclusion & Diversity

At ChristianaCare, we’re committed to treating everyone with dignity and respect. We believe in a safe, inclusive work environment that fosters collaboration between caregivers from all walks of life. We know that each unique viewpoint is vital in delivering high-quality, safe patient care to everyone who walks through our doors. Our policies, benefits, hiring practices, employee resource groups, and corporate citizenship demonstrate our commitment to inclusion and diversity throughout our system.

Why do we embrace inclusion and diversity? For the Love of Health.

Our Values

We serve together in Love and Excellence. Our unique values, Love and Excellence are bold and powerful, and they are the reason why working for ChristianaCare is special. The behaviors associated with our values guide how caregivers interact with everyone they work with and make for an exceptional work experience. We believe that when you lead with Love, Excellence is inevitable.

Benefits

ChristianaCare’s comprehensive total rewards package is one of the most competitive in the region. We are proud to offer excellent benefits that reflect the organization’s commitment to being exceptional today and even better tomorrow.

At ChristianaCare, we provide access to high-quality and affordable benefits designed to meet our caregivers where they are. You can tailor your benefits to meet your needs now and adjust them as your priorities change.

Take advantage of ChristianaCare’s wide-ranging benefit offerings from supporting optimal health through medical, prescription, dental and vision coverage to valuable wellness and work/life programs, which include paid parental leave, coverage for infertility and assisted reproductive technologies, an employer-funded short-term disability program, and more.

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Our Region

A Great Place To Live

Our region offers a diversity of cultures, lifestyles, sports and entertainment events, housing options and educational opportunities. Located between Philadelphia and Washington, D.C., our locations provide easy access to two international airports, employment opportunities in a tri-state area, and proximity to some of the nation's top universities and colleges, as well as beaches in MD, DE and NJ!

Why Delaware? Why Maryland?
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We Serve Together

For the Love of Health

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