Managed Care Finance Director jobs in Utah

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/ insurance or healthcare
  • Top Tier Consulting LLC
  • Sandy, UT FULL_TIME
  • Responsibilities:
    -Director, Managed Care

    • Sandy, UT, United States
    • Full Time
    • 10 paid holidays, 6% 401 k match, PTO, tuition reimbursement, and more

    Position

    The Claims Services department has an immediate opening for someone who can demonstrate the WCF values to join their team as a full-time Director, Managed Care. This posting is open to internal and external candidates and will work out of the Sandy, Utah headquarters.

    Responsibilities

    • Oversee the overall performance and outcomes of the managed care departments including Utilization Review, Medical Case Management, Vocational Rehabilitation, and Bill Review.
    • Collaborate with internal stakeholders, such as claims management, underwriting, legal, and finance, to ensure effective coordination of managed care initiatives.
    • Build and maintain relationships with external partners, including medical providers, pharmacy benefit managers, and other vendors.
    • Develop and implement strategic initiatives to enhance our managed care programs, ensuring alignment with organizational goals and objectives.
    • Leverage data analytics and industry best practices to optimize patient outcomes, reduce costs, and streamline processes.
    • Collaborate with internal stakeholders, such as claims management, underwriting, legal, and finance, to ensure effective coordination of managed care initiatives.
    • Build and maintain relationships with external partners, including medical providers, pharmacy benefit managers, and other vendors.
    • Ensure compliance with all relevant state and federal regulations governing managed care programs, staying up to date on industry changes and implementing necessary adjustments to maintain compliance.
    • Develop and track key performance indicators (KPIs) to evaluate the success of managed care programs.
    • Provide regular reports and analysis to claims management, highlighting program performance, outcomes, and opportunities for improvement

    Qualifications

    The most qualified applicants will have:

    • At least 6-8 years of experience in managed care, healthcare administration, or a similar role within the insurance industry.
    • Strong knowledge of workers' compensation regulations, managed care principles, and medical treatment guidelines.
    • Familiarity with utilization review processes, case management principles, and pharmacy benefit management is highly desirable.
    • Proven experience in managing and leading cross-functional teams and departments.
    • Excellent communication and interpersonal skills, with the ability to build and maintain relationships with internal and external stakeholders.
    • Strong analytical and problem-solving abilities, with proficiency in data analysis and reporting.
    • Demonstrated ability to drive process improvements and implement innovative solutions.
    • Bachelor's degree in healthcare administration, business administration, or a related field. Master's degree preferred.

    An internal candidate should have six months in their current position, acceptable job performance, and must notify their current supervisor that they've applied for the position.

    INSURANCE DE&I MISSION

    Promote and embrace a diverse, inclusive, equitable, and safe workplace.

    INSURANCE IS AN EQUAL OPPORTUNITY EMPLOYER

    Insurance provides equal employment opportunity to all qualified applicants and employees regardless of race, color, religion, sex, age, national origin, veteran status, disability that can be reasonably accommodated, or any other basis prohibited by federal, state, or local law.

    Job Type: Full-time

    Pay: $155,000.00 - $165,000.00 per year

    Benefits:

    • 401(k)
    • Dental insurance
    • Health insurance
    • Life insurance
    • Paid time off
    • Vision insurance

    Experience level:

    • 6 years
    • 7 years
    • 8 years

    Schedule:

    • Monday to Friday

    Work Location: In person

  • 4 Days Ago

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Project Finance Associate / Associate Director / Director
  • US Development Finance Corporation (formerly...
  • Salt Lake, UT FULL_TIME
  • Duties As a Project Finance Specialist, you will: Handle a range of activities in the structured debt finance origination process, including reviewing business plans, off-take agreements and other con...
  • 21 Days Ago

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Case Manager - Managed Care
  • Weber Human Services
  • Ogden, UT FULL_TIME
  • Job Description: Help coordinate mental health, medical, substance abuse services and social service needs of the adult mental health clients. Ensure clients have needed resources by linking, assistin...
  • Just Posted

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Director of Finance
  • Lodging Dynamics
  • Provo, UT FULL_TIME
  • Location: Hybrid position working in Provo and Midway, Utah. JOB SUMMARY The Director of Finance functions as the property's strategic financial business leader. This position provides continuous lead...
  • 22 Days Ago

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Director of Finance
  • Black Rock Mountain Resort
  • Heber, UT FULL_TIME
  • Location Description: Embrace a career surrounded by Utah's natural beauty, with Black Rock Mountain Resort offering a perfect balance of work and play in the picturesque landscapes of Heber City. As ...
  • 10 Days Ago

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Director of Finance
  • House of Hope
  • Salt Lake, UT FULL_TIME
  • INTRODUCTION:House of Hope (HOH) is in search of a talented, experienced, and creative individual to manage all financial/fiscal functions of our non-profit organization. Reporting to the Executive Di...
  • 15 Days Ago

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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 ...
  • 3/29/2024 12:00:00 AM

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VP, Chief Finance Officer
  • WVU Medicine Thomas Hospitals
  • South Charleston, WV
  • Provides executive management support in planning, organizing and directing fiscal related functions to include financia...
  • 3/29/2024 12:00:00 AM

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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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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
  • 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
  • Pridestaff
  • Shenandoah, VA
  • Job Description Job Description Are you a seasoned financial leader ready to take on a pivotal role in the Shenandoah Va...
  • 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

Utah is known for its natural diversity and is home to features ranging from arid deserts with sand dunes to thriving pine forests in mountain valleys. It is a rugged and geographically diverse state that is at the convergence of three distinct geological regions: the Rocky Mountains, the Great Basin, and the Colorado Plateau. Utah is one of the Four Corners states, and is bordered by Idaho in the north, Wyoming in the north and east; by Colorado in the east; at a single point by New Mexico to the southeast; by Arizona in the south; and by Nevada in the west. It covers an area of 84,899 sq mi ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Finance Director jobs
$134,593 to $173,922

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