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Under the supervision of the LCMC System Director of Managed Care, the Manager of Managed Care is responsible for duties related to managed care contracting and employer relations operations. The Manager of Managed Care will participate in the development of the LCMC System contracting and employer relations strategy for hospitals and physicians. This position will provide support to the Director of Managed Care in evaluation of new payer agreements, establishing negotiations goals, negotiating contract renewals and deployment LCMC’s employer relation strategy.

EXPERIENCE QUALIFICATIONS

5 years of experience with Managed Care, Payor or Provider Contracting.
Experience in marketing insurance products and insurance benefit design is a plus.

EDUCATION QUALIFICATIONS

Bachelor’s degree in healthcare management, Accounting, Business, or other related field

Strategy:

• Participates in development of and executes managed care and employer/broker strategy for LCMC hospitals and physicians.
• Responsible for identifying opportunities for LCMC to grow market share.
• Establishes productive business relationships with payor representatives and participates in JOCs.
• Manages the planning process for contract renewals and negotiations including assessment of historical performance and issues as well as identification of payor specific issues.

Analysis:

• Provides analysis and summary of reimbursement and language terms of payor contracts.
• Works closely with analytics staff and legal counsel to review proposed agreements.
• Ensure all documents associated with the negotiated payor agreement are in contract management systems correctly at all times.
• Provide biweekly updates on significant payer issues.
• Ensures that all deadlines for initial credentialing and renewals for hospital are met.

Employer Relations:

• Supports LCMC’s employer and insurance broker relationship strategy.
• Responsible to identify key payers, brokers, employers, and employee groups in the Hospitals primary and secondary service areas and develop relationships of trust within these groups in order to identify and advise them on market opportunities which would support LCMC’s growth strategy.
• Assist in the development and presentation of LCMC Hospitals tactics to assist Payers, Brokers, and Employers in cost affective alternatives to consider during their benefit selection process and impact that decision making process.