Manager - Managed Care (Division position, growth potential, excellent benefits)
Company: Acadia Healthcare
Location: San Jose
Posted on: September 22, 2022
- Assists facilities in managed care contracting and revenue
enhancement strategies for their area.
- Uses data to determine areas where rates can be potentially
- Review rates and renewal dates by payer and facility to ensure
facilities are negotiating rates timely and that rate requests are
appropriate. Owns negotiation, when appropriate.
- Provides guidance to facilities regarding development of
managed care relationships and rates.
- Assists facilities with ensuring managed care contracts are
acceptable according to organizations required standards, and is
responsible for pre-screening managed care contract terms prior to
uploading to contract system for legal review. Assists in execution
and implementation of contract changes.
- Negotiates contracts for startup facilities and facilities who
change from a self-pay model to a more diversified business model
to include managed care.
- Provides guidance on payor-related documents and forms needed
for network participation and advises on making changes to network
status including but not limited to: services offered, locations,
and participating products.
- Assists facilities with issues with major payors such as
contract disputes and denials.
- Work with facilities to monitor the impact of specific managed
care strategies and contracts. Evaluates opportunities to grow net
revenue by contracting and/or terminating contracts with
- Assist business development staff to ensure volume growth with
key payors and achieve a balanced payor mix.
- Provide ongoing training to facility staff on-site or via
regularly scheduled conference calls.
- Works with Vice President of Managed Care to maintain current
knowledge of managed care trends and changes and ensure facilities
are prepared for changes and remain compliant.
- Works with division leadership and Corporate UM/Intake/Business
Office staff to ensure payer related challenges and opportunities
are addressed collaboratively.
- Works with facility to develop managed care pitch to secure
- Surveys managed care organizations needs and assists in
evaluating potential growth opportunities.OTHER FUNCTIONS:
- Performs other duties as assigned.STANDARD EXPECTATIONS:
- Complies with organizational policies, procedures, performance
improvement initiatives and maintains organizational and industry
policies regarding confidentiality.
- Communicate clearly and effectively to person(s) receiving
services and their family members, guests and other members of the
health care team.
- Develops constructive and cooperative working relationships
with others and maintains them over time.
- Encourages and builds mutual trust, respect and cooperation
among team members.
- Maintains regular and predictable attendance.
- Excellent interpersonal skills and ability to work with payors
/ managed care organizations and forge long standing Payor-Provider
- Knowledge of office administration procedures with the ability
to operate most standard office equipment.
- Ability to work professionally with sensitive, proprietary data
& information while maintaining confidentiality.
- Exercises sound and strategic judgment in responding to
inquiries; understands when to route inquiries to next level.
- Self-motivated with strong organizational skills and superior
attention to detail.
- Must be able to manage multiple tasks/projects simultaneously
within inflexible time frames. Ability to adapt to frequent
- Capable of working within established policies, procedures and
practices prescribed by the organization.
- English sufficient to provide and receive
- EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
- Bachelors degree in business or healthcare related field.
- Minimum 5 years contract experience in a health care
facility/system or managed care organization. Previous behavioral
healthcare experience preferred.
- Knowledge of laws, regulations and rules related to healthcare
and managed care.
- Knowledge of major payors, reimbursement, and value based
- Effective and accurate oral and written communication skills.
Ability to communicate interdepartmentally to include Business
Office, UM, Clinical, Finance Operations, Compliance, Legal, and
Senior Leaders. LICENSES/DESIGNATIONS/CERTIFICATIONS:
- Not ApplicableSUPERVISORY REQUIREMENTS: This position is an
Individual ContributorEqual Opportunity Employer/Protected
Veterans/Individuals with DisabilitiesThe contractor will not
discharge or in any other manner discriminate against employees or
applicants because they have inquired about, discussed, or
disclosed their own pay or the pay of another employee or
applicant. However, employees who have access to the compensation
information of other employees or applicants as a part of their
essential job functions cannot disclose the pay of other employees
or applicants to individuals who do not otherwise have access to
compensation information, unless the disclosure is (a) in response
to a formal complaint or charge, (b) in furtherance of an
investigation, proceeding, hearing, or action, including an
investigation conducted by the employer, or (c) consistent with the
contractors legal duty to furnish information. 41 CFR
Keywords: Acadia Healthcare, San Jose , Manager - Managed Care (Division position, growth potential, excellent benefits), Executive , San Jose, California
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