Silver Cross
Operations Manager, Managed Care
New Lenox, Illinois · Part-time
Sponsorship not specifiedDetected 8 hours ago
Compliance
About the role
- The Operations Manager, Managed Care is responsible for the day-to-day operations of the PHO's governmental and managed care contracts to help position the network physicians strongly with new programs, networks and relationships.
- The Position reports to the Administrative Director of Value Based Care
- Run day to day operations that will help enhance and expand revenues for the Hospital through contracts with commercial and governmental payors.
Responsibilities
- Implement and manage utilization management, quality and risk coding program.
- Identify ways to offer gain sharing opportunities to network physicians and steps to implement programs.
- Proactively communicate and create strong relationships with physicians, colleagues, and payor contacts.
- Implement strategy for network development inclusive of but not limited to provider relations, credentialing, and network management of the PHO and EHP.
- Align and maintain portfolio of contacts to assure consistency and sustainability.
- Employee decision support tools to model and identify opportunities to negotiate improved pricing.
- Enhance and develop clinical integration and financial integration programs for network physicians and manage the PHO's regulatory compliance of the programs.
Requirements
- Bachelors degree in Business Administration or related field required.
- Experience with Medicare Advantage
Nice to have
- Direct Contracting with Large employers preferred
Compensation
- Review contracts annually, for both the Hospital and PHO, and execute appropriate management strategies to ensure profitability.
Benefits
- At Silver Cross Hospital, we care about your health and well-being and that is why we work hard to provide quality and affordable benefit options for you and your eligible family members.
- Silver Cross Hospital and Silver Cross Medical Groups offer a comprehensive benefit package available for
- Medical, Dental and Vision plans
- Flexible Spending Account
- Other voluntary benefit plans
- However, registry employees are ineligible for Health and Welfare benefits.
- 10 years' experience in healthcare at commercial payors, hospitals or consulting firms
- Relation with local commercial payor healthcare executives
- Significant experience contracting and population health programs
Company info
- Silver Cross Hospital is an extraordinary place to work.
- We're known for our culture of excellence and delivery of unrivaled experiences for our patients, their families, the communities we serve…and for each other.
- Come join us!
- It's the way you want to be treated.
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This listing is sourced directly from Silver Cross's careers page and normalized into a canonical job model.