Managed Care Finance Director jobs in Florida

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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Director of Managed Care
  • Central Florida Health Care, Inc.
  • Winter, FL FULL_TIME
  • Title: ____Director of Managed Care________
    Reports to: ____Assistant Chief Medical Officer
    FLSA Status: ____Exempt_________________ Personnel Supervised: ___Case Management Team Members______

    POSITION SUMMARY:
    The Director of Managed Care will work in coordination and cohesively with the Managed Care team to ensure the successful implementation of Managed Care goals. The main focus of this position will be to improve the health of CFHC patients through outreach and engagement in preventive care and management of chronic health conditions, as well as ensuring the effective utilization of health care resources by managed care patients. The Director of Managed Care will provide supervision to the members of the Managed Care Team in their endeavors to improve overall patient outcomes with their quality of health. Additionally, the Director of Managed Care will
    oversee the strategy of successful managed care contract performance.

    The Director of Managed Care is responsible, and accountable for establishing, assuring, and assessing quality improvement controls which reflect the most appropriate and effective use of resources in the delivery of primary care within CFHC’s service areas.
     
    The duties outlined which include, but are not limited to, shall be performed in accordance with the defined business process using the corporation’s policies, procedures, Mission and Vision Statements, CFHC’s Performance Expectations, CFHC’s Quality Improvement Plan (QIP), Health Resources Services Administration (HRSA) Compliance, Joint Commission’s Standards and all other Federal and State Guidelines.

    MINIMAL QUALIFICATIONS:
    • Bachelor's degree in healthcare administration, business, or related field; Master’s degree preferred.
    • Valid Driver’s License
    • Ability to work effectively with a diverse multidisciplinary team of health care professionals and staff.
    • Ability to manage multiple responsibilities and to prioritize scheduling of work.
    • Excellent internal and external customer relationship skills.
    • Excellent analytical and problem-solving skills.

    EXPERIENCE:
    • Minimum of 3 years of experience in managed care.
    • Experience with electronic medical records.
    • Preferred prior experience with Population Health Tools.
    • Experience in evaluating and measuring quality measures.
    • Experience with Utilization Review
    • Experience analyzing Managed Care contracts.
     
    KNOWLEDGE AND SKILLS:
    1. Knowledge of patient teaching and education (example: self-blood pressure monitoring, nutrition instruction, diabetes self-care instructions).
    2. Knowledge of common medical supplies and equipment.
    3. Excellent interpersonal, communication and leadership skills.
    4. Ability to demonstrate priority-setting and ability to work in a complex environment.
    5. Ability to function with a high degree of independence and collaboration with other health care providers.
    6. Commitment to service, quality, and departmental core values.
    7. Proficient in data collection and analysis.
    8. Proficient in Microsoft Office suite.
    9. Intermediate typing skills.
    10. Knowledge of medical terminology.
    11. Ability to work under tight deadlines and remain flexible.
    12. Exceptional team, communication, and written/oral skills.

    RESPONSIBILTIES AND PERFORMANCE EXPECTATIONS include, but are not limited to, the following:
    1. Use Data and insights to drive improvements in health outcomes utilization.
    2. Obtain/maintain proficient knowledge of CFHC’s mission, vision, overarching goal, and performance expectations.
    3. Be well versed in the company’s policies and procedures as well as state/federal guidelines and standards of other regulatory agencies.
    4. Maintain seamless communication with Assistant Chief Medical Officer for program guidance, goals for outcomes, and reporting of Managed Care outcomes.
    5. Provide excellent leadership and work cohesively with the Managed Care Team to identify efficient processes for improved patient health care outcomes as well as training tools to educate all pertinent staff.
    6. Manage case assignments, develop plans for improvement, track progress and oversee outcomes for the Managed Care program.
    7. Collaborate with Chief Informatics Officer and/or Data Analyst to obtain accurate reports for quality measure outcome information.
    8. Coordinate and facilitate patient care through assessment, evaluation, planning, and implementation.
    9. Collect, analyze, and report data on established performance measures related to quality outcomes.
    10. Oversee the patient engagement strategy for assigned panels and optimizing scheduling based on the patient’s need for preventative care or chronic disease management.
    11. Oversee patient panel hospital utilization.
    12. Integrate evidence from multiple sources to determine how best to coordinate patient care.
    13. Maintain communication with managed care insurance companies as it relates to patient panels, and contract performance.
    14. Identify patients who are due or overdue for preventive care as well as ongoing monitoring for chronic conditions.
    15. Attend meetings in coordination with the appropriate staff, as requested.
    16. Coordinate, as necessary, with other staff members, Department Heads, supervisors, and all other appropriate agencies.
    17. Prior to leave (annual and other) provide the Supervisor with a highlighted picture of major or other significant projects underway.
    18. Able to work independently as this position may not be in the same physical office space as the other Managed Care Team members for daily routine responsibilities. In addition, this position may require travel to all centers to coordinate patient care.
    19. Perform other duties as assigned or necessary.

    PHYSICAL REQUIREMENTS:
    1. Able to work flexible hours (normal hours will be 8:00am – 5:00pm)
    2. Standing/walking/sitting for long periods
    3. Independently mobile
    4. Ability to lift equivalents to what would be required when (and if) asked to assist and position patients, reposition equipment and lift supplies.
    5. Ability to adapt and function in varying environments of workload, patient acuity, worksites, and work shifts.

  • 26 Days Ago

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Medical Director, Managed Care
  • Access Healthcare Physicians, LLC
  • Spring, FL FULL_TIME
  • Summary: Responsible for administration of all clinical aspects of the Quality Management Program; works closely with the CEO and Quality Management Steering Committee (QMSC) in administering the enti...
  • 4 Days Ago

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Director of Managed Care Contracting
  • Sanitas
  • Doral, FL OTHER
  • Job Details Job Location: Miami Dade - Corporate - Doral, FL Salary Range: Undisclosed DescriptionJob Overview: The Director of Managed Care Contracting is accountable for achieving financial and busi...
  • 17 Days Ago

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Senior Director of Managed Care Contracting
  • Sanitas
  • Doral, FL OTHER
  • Job Details Job Location: Miami Dade - Corporate - Doral, FL Salary Range: Undisclosed DescriptionJob Overview: The Director of Managed Care Contracting is accountable for achieving financial and busi...
  • Just Posted

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Director of Finance
  • FLORIDA JOINT CARE INSTITUTE
  • Trinity, FL FULL_TIME
  • Job Summary:We are seeking a highly skilled and experienced Director of Finance to oversee our company's financial operations and strategic growth. The ideal candidate will have a strong background in...
  • Just Posted

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Managed care
  • The Hartford
  • Lake, FL FULL_TIME
  • Subro Claim Handler - CI09CN We’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to...
  • 3 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

Florida (/ˈflɒrɪdə/ (listen); Spanish for "land of flowers") is the southernmost contiguous state in the United States. The state is bordered to the west by the Gulf of Mexico, to the northwest by Alabama, to the north by Georgia, to the east by the Atlantic Ocean, and to the south by the Straits of Florida. Florida is the 22nd-most extensive (65,755 sq mi or 170,300 km2), the 3rd-most populous (21,312,211 inhabitants), and the 8th-most densely populated (384.3/sq mi or 148.4/km2) of the U.S. states. Jacksonville is the most populous municipality in the state and the largest city by area in th...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Finance Director jobs
$135,132 to $174,619

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