Elevate your career at Wood County Hospital, where you're not just a number – you're a vital part of a team making a real difference.
Manager, Managed CareThe Manager, Managed Care, supports the effective administration, analysis, and implementation of payer contracts to ensure compliance, operational accuracy, and alignment with organizational financial and performance goals. This role serves as a key liaison between payers and internal stakeholders to support optimal reimbursement and contract performance. The Manager, Managed Care, is an onsite position.
Essential Functions
* Administer and interpret payer contracts by maintaining documentation, reviewing payer updates, and coordinating resolution of contract changes.
* Analyze managed care data by producing ad hoc reports, fiscal summaries, and tools to support revenue cycle teams.
* Coordinate contract management system accuracy, compliance requirements, and required payer attestations.
* Collaborate with internal departments to implement payer contracts, communicate initiatives, and ensure contractual obligations are met.
* Serve as liaison with contracted health plans by maintaining payer relationships, supporting credentialing activities, and resolving payer-related issues.
* Prepare, prevent, protect and respond to support our culture of safety.
* Works hours per week in accordance with offer letter or per attributes of position at transfer request.
* Resolves disputes or issue independently, without routine escalation needed.
* May be expected to work longer hours as necessary.
* Other duties as assigned.
Requirements
Education: Bachelor's degree in business, healthcare administration, or related field.
License: None
Experience: Two (2) years in healthcare related payer relations/contracts or other related revenue cycle role.
Certification: None
Preferred
Education: None
License: None
Experience: None
Certification: None
PHYSICAL REQUIREMENTS
1.In an 8 to 12-hour workday, employee stands/walks (hours at one time):
[x] 0-2 [] 2-4 []4-6 [] 6-8 [] 8-12
2. In an 8- to 12-hour workday, employees sit (hours at one time/hour during the day):
[] 0-2 [] 2-4 [x]4-6 [] 6-8 [] 8-12
3. Employee lifts:
[x] up to 10 # [] 10-20 # [] 20-50 # [] over 50 #
4. Lifting as indicated in item 3 above is performed during the workday:
[x] occasionally [] frequently [] continuously
5. Employee uses hands for repetitive:
a. Simple grasping: [x] yes [] no
b. Pushing/pulling: [x] yes [] no
c. Fine manipulation: [x] yes [] no
6. Employee uses feet for repetitive movement in operating foot controls:
[] yes [x] no
7.Employee must be able to:
a. Bend: [] frequently [x] occasionally [] not at all
b. Squat: [] frequently [x] occasionally [] not at all
c. Kneel: [] frequently [x] occasionally [] not at all
d. Climb: [] frequently [x] occasionally [] not at all