Managed Care Supervisor jobs in Maryland

Managed Care Supervisor supervises and coordinates activities of personnel in the managed care operations department of a healthcare facility. Oversees staff that process referrals, authorizations, billing, utilization review, and capitation for hospital services. Being a Managed Care Supervisor experienced in utilization review techniques and protocols. Requires a bachelor's degree. Additionally, Managed Care Supervisor typically reports to a manager or head of a unit/department. May require Registered Nurse (RN). Makes day-to-day decisions within or for a group/small department. Has some authority for personnel actions. The Managed Care Supervisor supervises a group of primarily para-professional level staffs. May also be a level above a supervisor within high volume administrative/ production environments. To be a Managed Care Supervisor typically requires 3-5 years experience in the related area as an individual contributor. Thorough knowledge of functional area and department processes. (Copyright 2024 Salary.com)

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Manager of Managed Care Contracting
  • Anne Arundel Dermatology
  • Linthicum Heights, MD FULL_TIME
  • Overview

    Reporting to the Chief Compliance Officer, the Manager of Managed Care Contracting is responsible for overseeing the development, strategic planning and execution of managed care contracts for the company through market assessment, financial modeling and relationship management.

     

    Responsibilities

    Supervisory Responsibilities:

    • Recruits, interviews, hires, and trains management level staff in the department.
    • Oversees the schedules and responsibilities of management-level staff in the department.
    • Provides constructive and timely performance evaluations.

    Duties/Responsibilities:

    • Define the strategy for each negotiation, including evaluation of strategic pricing, fee-for service, engagement in value-based contract structures, bundled arrangement, insurer product development, etc. to strengthen the company’s position in the market place.
    • Develops and maintains a network of relationships with third party payers.
    • Drives and maintains strong relationships with internal clinical providers and groups to facilitate and encourage partnership and development.
    • Drafts, reviews and negotiates all managed care payer contracts for assigned payers, including ones flexible enough to respond to an ever-changing market over multi-year agreements.
    • Oversees analytics and other quantitative revenue analysis that supports contract strategy
    • Creates methods to evaluate and analyze existing contracts to determine initiatives for cost reduction and continual improvement.
    • Negotiates contracts and utilizes strategies for the interpretation and assessment of legal and financial implications.
    • Maintains and provides in-depth knowledge of managed care concepts, contracting terms, risk arrangements and State and Federal laws that apply to managed care in order to effectively negotiate or supervise negotiation of agreements with Payors.
    • Collaborates with senior executives to support company growth.
    • Forecasts, drafts, implements, and oversees the department’s operating budget, ensuring maximum utilization of resources for optimal results.
    • Maintains standards and ensures compliance across all managed care contracting related channels.
    • Required to travel as needed.

    Qualifications

    Required Skills/Abilities:

    • Significant knowledge of managed care payer operations and physician contracting
    • Knowledge of current trends in health insurance and the managed care marketplace.
    • Outstanding verbal and written communication skills.
    • Excellent interpersonal and customer service skills.
    • Excellent organizational skills and attention to detail.
    • Professional level knowledge of health care administration, finance and clinical operations.
    • Proficient with Microsoft Office Suite or related software.

    Physical Requirements:

    • Prolonged periods of sitting at a desk and working on a computer.
    • Must be able to lift 15 pounds at times.

     

    Licensure/Certifications/Education

    Education and Experience:

    • Bachelor’s degree in healthcare administration or similar related field. Master’s degree preferred.
    • Five to Seven years progressively responsible experience in health insurance and managed care, with significant leadership experience preferred.
    • Prior experience in the healthcare or dermatology industry is highly desired.
  • 22 Days Ago

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Managed Care Billing Specialist
  • FutureCare
  • Pasadena, MD FULL_TIME
  • Overview At FutureCare our Managed Care Billing Specialist position is a general patient accounting position with a variety of duties related to day to day review, input, processing and coordinating o...
  • Just Posted

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Clinical Quality Managed Care Specialist
  • Johns Hopkins Health Plans
  • Hanover, MD FULL_TIME
  • Who you are: As a Clinical Quality Managed Care Specialist, you are a guru when it comes to working in a NCQA-accredited managed care organization. You not only understand Clinical HEDIS and Stars Mea...
  • 1 Day Ago

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Clinical Quality Managed Care Specialist
  • Johns Hopkins Medicine
  • Hanover, MD FULL_TIME
  • Who you are: As a Clinical Quality Managed Care Specialist, you are a guru when it comes to working in a NCQA-accredited managed care organization. You not only understand Clinical HEDIS and Stars Mea...
  • 4 Days Ago

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Claims Auditor
  • Jai Medical Systems Managed Care Organization, Inc.
  • Cockeysville, MD FULL_TIME
  • Baltimore-based Medicaid Managed Care Organization company is seeking a hardworking and reliable individual for Claims Auditor position. The Claims Auditor will review and analyze claims data, profess...
  • 20 Days Ago

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Managed Care Centralized Business Office Manager
  • CommuniCare Family of Companies
  • Linthicum Heights, MD FULL_TIME
  • CommuniCare Health Services is currently recruiting a Managed Care Team Lead / Centralized Billing Office Manager for our Central Billing Office in Linthicum Heights, MD.PURPOSE/BELIEF STATEMENTThe Ma...
  • 25 Days Ago

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Nutrition Care Supervisor
  • HumanGood
  • Jenkintown, PA
  • Rydal Park & Waters, a premier Life Plan Community located in Jenkintown, is hiring a Nutrition Care Supervisor to join ...
  • 3/28/2024 12:00:00 AM

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Client Care Supervisor
  • Family Resource Home Care
  • Bellingham, WA
  • Family Resource Home Care is a leading home care agency dedicated to providing high-quality, compassionate care to our c...
  • 3/28/2024 12:00:00 AM

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Animal Care Supervisor
  • VCA Animal Hospitals
  • Boca Raton, FL
  • We are seeking a highly experienced Animal Care Professional to join our leadership team as Animal Care Supervisor. The ...
  • 3/28/2024 12:00:00 AM

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Animal Care Supervisor
  • Petco Animal Supplies Inc
  • Pompano Beach, FL
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 3/28/2024 12:00:00 AM

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Customer Care Supervisor
  • PLS Financial Services, Inc.
  • Oak Brook, IL
  • Overview: PLS: People. Location. Service PLSwhich stands for People Location - Serviceis a leading retail provider of al...
  • 3/27/2024 12:00:00 AM

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Animal Care Supervisor
  • Petco Animal Supplies, Inc.
  • Milltown, NJ
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 3/27/2024 12:00:00 AM

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Animal Care Supervisor
  • Petco Animal Supplies Inc
  • Milltown, NJ
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 3/25/2024 12:00:00 AM

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Respiratory Care Supervisor
  • Essentia Health
  • Detroit Lakes, MN
  • Job Description: In this position you will provide support for the development and implementation of strategic and opera...
  • 3/14/2024 12:00:00 AM

Maryland (US: /ˈmɛrələnd/ (listen) MERR-əl-ənd) is a state in the Mid-Atlantic region of the United States, bordering Virginia, West Virginia, and the District of Columbia to its south and west; Pennsylvania to its north; and Delaware to its east. The state's largest city is Baltimore, and its capital is Annapolis. Among its occasional nicknames are Old Line State, the Free State, and the Chesapeake Bay State. It is named after the English queen Henrietta Maria, known in England as Queen Mary. Sixteen of Maryland's twenty-three counties border the tidal waters of the Chesapeake Bay estuary and...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Supervisor jobs
$78,890 to $108,881

Managed Care Supervisor in Columbia, SC
The Supervisor Business Services of Government Billing and Collections will be responsible for the overall AR management of all government inventory.
January 02, 2020
Managed Care Supervisor in Colorado Springs, CO
In Service to Our Community is achieved through streamlined, coordinated and comprehensive high-quality, compassionate care close to home.
February 15, 2020
Managed Care Supervisor in Portland, ME
·        Minimum one year resolving claims issues with Payer Relations representatives to handle managed care contract implications.
February 19, 2020