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)
Cabell Huntington Hospital is seeking a full-time Managed Care Financial Analyst to work alongside our Contract Management Department.
The Managed Care Financial Analyst is responsible for ensuring accuracy of third party insurance payments according to contractual and state/federal reimbursement guidelines and policy. Identifies underpayments and works with patient accounting department and third party payor to resolve/appeal. Assist in payor relations and provider contracting. Maintains contract management pricing software. Negotiates single case agreements. Assist in preparation, maintenance, and compliance of pricing transparency requirements and disclosures. Assist in various other financial analysis.