Managed Care Finance Director jobs in Alabama

Managed Care Finance Director directs and oversees all policies and procedures for the financial and data operations of managed care contracts. Manages contracts, negotiates and sets rates, and reviews reimbursement levels and managed care agreements to ensure that proper payment practices are utilized. Being a Managed Care Finance Director implements processes that encourage and inform the organization how to increase levels of reimbursements. Requires a bachelor's degree. Additionally, Managed Care Finance Director typically reports to top management. The Managed Care Finance Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Managed Care Finance Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)

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Managed Care Contract Specialist
  • Highmark Health
  • AL, AL FULL_TIME
  • Description

    GENERAL OVERVIEW :

    This job serves as the primary negotiator for Single Case Agreements related to non-contracted entities, while also being responsible for facility / ancillary credentialing for the entire Allegheny Health Network.

    It maintains compliance with the No Surprises Act by reviewing andnegotiating Qualified Payment Amounts, administering and serving as the subject matter expert (SME) for the Electronic Contract Repository, and maintaining Network Participation Tools for internal and external consumption.

    ESSENTIAL RESPONSIBILITIES

    Negotiates and processes payor and employer single case agreements timely and accurately. Continually follows up on singe case agreements until complete and ensures compliance with terms of the single case agreement.

    Collaborates with Allegheny Health Network (AHN) Revenue Cycle and Managed Care team to ensure proper billing and timely follow-up on single case agreements. 40%

    Completes and submits facility credentialing and re-credentialing applications with all payors accurately and in a timely manner (including but not limited to hospital, ASC, and ancillary entities.

    Resolves credentialing issues through collaboration with management, related departments, insurers and others as identified.

    Monitors and maintains key credentialing dates for all payors.15%

    • Manages Out-of-Network work queue and evaluates Qualified Payment Amounts. Ensures organizational compliance with No Surprises Act Requirements by negotiating single care agreements timely.15%
    • Administers the Contract Repository System and ensures that Managed Care Contracts are stored timely and accurately into Contract Repository system.

    Serves as primary intake for new contract documents and catalogs pertinent contracting language and events. Serves as department SME for Contract Repository System.10%

    Maintains patient access matrix for internal consumption. Maintains and updates patient access matrix for external consumption.

    Collaborates with IT and Marketing to ensure timely updates to company websites.10%

    • Coordinates special projects and provides organizational support for the Managed Care department.Ensures that project deadlines are met and project documentation is maintained appropriately. 10%
    • Other duties as assigned or requested.

    QUALIFICATIONS : Minimum

    Minimum

    • Bachelor's Degree in Finance, Accounting, Business Administration, Economics, Statistics, or related field, or 6 years of progressive healthcare related experience as determined by the company in lieu of bachelor's degree
    • 3 years of healthcare related experience
    • Advanced computer skills using Microsoft Office (Word, Excel, and PowerPoint, Adobe, etc.)
    • Substantial organizational skills, including multitasking and time-management
    • Reliable customer service, follow-up, and communication skills
    • Ability to work effectively both independently and as part of a team
    • Continuously searches for process improvements to achieve accuracy and efficiencies
    • Strong critical thinking, problem solving abilities, and attention to detail

    Preferred

    1 year of Managed Care experience

    Pay Range Minimum : $25.85

    $25.85

    Pay Range Maximum : $40.18

    $40.18

    Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation / gender identity or any other category protected by applicable federal, state or local law.

    Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation / gender identity, protected veteran status or disability.

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    Equal Opportunity Employer Minorities / Women / Protected Veterans / Disabled / Sexual Orientation / Gender Identity ()

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    2 days ago
  • 5 Days Ago

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Director of Finance
  • powerhrllc
  • Huntsville, AL FULL_TIME
  • Shift Type First Shift Job Title Director of Finance Education Bachelor's Degree Location Remote Huntsville, AL 35808 US (Primary) Career Level Manager Category Finance Date Needed By Job Type Full-ti...
  • 20 Days Ago

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Director of Finance
  • PangeaTwo
  • Birmingham, AL FULL_TIME
  • Director of Finance Birmingham, Alabama $120,000 - $140,000 We are assisting our client in their search for a Director of Finance that is a strategic and results-driven professional who can provide le...
  • 10 Days Ago

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Director of Finance
  • The Wellhouse
  • Alabama, AL FULL_TIME
  • POSITION SUMMARY: Responsible for related general business and accounting affairs. Serves as primary liaison between the organization and the independent external public accounting firm in connection ...
  • 12 Days Ago

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Director of Finance
  • Leonardo Electronics US Inc
  • Huntsville, AL FULL_TIME
  • The Director of Finance will be responsible for the direction and management of the Finance department at Sensor Solution. Reporting to the CFO of Leonardo Electronics US Inc and functionally to the V...
  • 1 Month Ago

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Hospital Finance Director-MIMC
  • Infirmary Health
  • Mobile, AL FULL_TIME
  • Overview Qualifications Minimum Qualifications: Bachelor’s degree in business or healthcare 5 of the most recent 7 years’ experience in a financial leadership role Demonstrates clear, consistent and e...
  • 20 Days Ago

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Chief Finance Officer (CFO)
  • Tandym Group
  • New York, NY
  • A Federally Qualified Health Center (FQHC) in New York is currently seeking an experienced Finance professional to join ...
  • 3/28/2024 12:00:00 AM

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CFO/Controller
  • GRIP - Training Institute
  • Berkeley, CA
  • CFO/Controller Organization: GRIP Training Institute: https://grip-traininginstitute.org Location, Hybrid: Berkeley, CA ...
  • 3/28/2024 12:00:00 AM

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Finance Director
  • CFO
  • Park Ridge, IL
  • Job Description Job Description Finance Director – Park Ridge, IL (Hybrid) Compensation: $150,000-$180,000 + Bonus and F...
  • 3/28/2024 12:00:00 AM

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CFO Controller
  • Distributor
  • Monroe, LA
  • Job Description Job Description Position: CFO / Financial Controller Location: Monroe, LA Benefits: Dental insurance Hea...
  • 3/26/2024 12:00:00 AM

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Chief Finance Officer (Healthcare)
  • Callen-Lorde Community Health Center
  • New York, NY
  • Job Description Job Description Are you ready to make a profound impact on the world of LGBTQ+ healthcare and lead a dyn...
  • 3/26/2024 12:00:00 AM

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Fractional CFO / Controller
  • W.W. Nash & Sons, Inc.
  • Richmond, VA
  • Company Description W.W. Nash & Sons, and W.W. Nash Construction Company are two dynamic companies working under the sam...
  • 3/25/2024 12:00:00 AM

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Senior Finance Director (Division CFO)
  • Korn Ferry
  • Houston, TX
  • Korn Ferry Professional Search has partnered with our client on their search for a Divisional CFO. This position will be...
  • 3/25/2024 12:00:00 AM

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CFO/Controller
  • GRIP - Training Institute
  • Berkeley, CA
  • CFO/Controller Organization: GRIP Training Institute: https://grip-traininginstitute.org Location, Hybrid: Berkeley, CA ...
  • 3/24/2024 12:00:00 AM

Alabama (/ˌæləˈbæmə/) is a state in the southeastern region of the United States. It is bordered by Tennessee to the north, Georgia to the east, Florida and the Gulf of Mexico to the south, and Mississippi to the west. Alabama is the 30th largest by area and the 24th-most populous of the U.S. states. With a total of 1,500 miles (2,400 km) of inland waterways, Alabama has among the most of any state. Alabama is nicknamed the Yellowhammer State, after the state bird. Alabama is also known as the "Heart of Dixie" and the "Cotton State". The state tree is the longleaf pine, and the state flower is...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Finance Director jobs
$130,680 to $168,866

Managed Care Finance Director in Waterloo, IA
Today, the Department of Health Care Finance (DHCF) announced that the Office of Contracting and Procurement (OCP) submitted to the Council of the District of Columbia a notice of intent to award three contracts for the District’s Medicaid managed care program.
January 27, 2020
Managed Care Finance Director in Biloxi, MS
Our executives lead the strategies and operations that help us deliver quality care across our network.
January 30, 2020
Managed Care Finance Director in Reno, NV
Facey Medical Group is a multi-specialty medical group with over 160 physicians providing care to the growing population in the North & East regions of Los Angeles & Ventura Counties.
December 30, 2019
Able to travel to all regional sites in a consistent, timely and efficient manner; holds effective meetings and leads workgroups, assigns and takes over deliverables, reports to and coordinates with the regional director and manager on the priorities and workload management; strives to exceed expectations.
January 24, 2020