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Director of Managed Care Contracting

Buffalo, NY

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Job Description
Requisition ID
# of Openings
Posted Date
Area of Interest
Position Type
Regular Full-Time
Are you looking to be part of a superior team in a growing and dynamic healthcare organization in Buffalo, NY? If so, this just might be the right opportunity for you! **MEMBERS ONLY**SIGN UP NOW***. has an exciting new position for a Director of Managed Care Contracting
to support our rapid expansion! This position reports to the Chief Financial Officer.

Our Excellent, Competitive Compensation, and Full Benefits Package includes:
Up and coming downtown location with FREE PARKING!
Competitive wages and opportunities for advancement
Medical, Dental, Vision Insurance
Life insurance
401(k) with match
Paid Holidays
Generous Paid Time Off
**MEMBERS ONLY**SIGN UP NOW***. was founded in 1978 and provides skilled nursing care, specialized subacute care, rehabilitation, assisted living, independent living and memory care services in western, central, and northern New York, Rhode Island and Pennsylvania. We are part of a larger group of health care companies owned by Post Acute Partners which currently employs nearly 5,000 employees.

Our employees are important members of the health care team at **MEMBERS ONLY**SIGN UP NOW***.. Our goal is to provide residents with the finest care possible. We work together as a team and continually seek excellence in our organizational performance.

The Director of Managed Care Contracting is responsible for new contract and existing contract negotiations, development of provider relationships and contract warehousing. Oversight and supervision of position responsible for education, contract tracking system, and payer contract credentialing. Oversight and supervision of Insurance and Third party payer Verification/Authorization staff.

Seek opportunities to engage new contractor relationships for existing facilities.
Manage contract process for all new acquisitions including identification of existing contracts as part of due diligence and determining what contracts will be considered for engagement under the new entity. Prior to ownership change, identify resident payer sources related to Managed care contracts, and coordinate with other AR and facility staff, a process for reimbursement, authorizations, billing until new contracts are established.
Develop new contract opportunities including negotiation of new contracts as well as monitoring required updates, adjustments and changes to existing contracts.
Script, negotiate and finalize contracts for implementation by organization based on predetermined parameters.
Interface with various departments in developing contractual proposals.
Keep current with changes to federal and state regulations and provider/industry trends as they affect contract structure in providing services.
Develop, maintain and keep current Policy and Procedure manual online for facility and organizational use.
Serve as a resource for facility and AR staff as they relate to reimbursement and payment terms of the contracts.
Develop and provide reporting to appropriate individuals as needed or requested.
Use tableau reports to generate P&L reports and develop comparison reimbursement scenarios for contract negotiations.
Supervise Managed Care Contract Coordinator and Insurance Authorization Manager.
Bachelor's Degree in healthcare or related field required.
Strong healthcare background, and long term care or pediatric business knowledge.
Experience in reimbursement and contract negotiation.
Must be familiar with hospital, long term care, physician, Medicare, Medicaid, and other third party commercial reimbursement methodologies as well as federal and state laws as they relate to those payer payment structures.
Strong communication skills are necessary to effectively work with providers and payers. Proficiency in Microsoft Word, Excel, Outlook as well as web based research preferred.
Microsoft Office skills required.
Equal Employment Opportunity/M/F/disability/protected veteran status. PI103350004
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