Senior Network Accounts Manager - Managed Care

Job Summary

Under general supervision of the Vice-President of Managed Care and managed by the Manager of Managed Care Operations, the Network Accounts Manager Sr develops, directs and/or performs analytical and planning functions in support of managed care decision making and proactively identifies areas of opportunity with regard to reimbursement for the hospital and practitioners. The Network Accounts Manager Sr will be integrally involved in Managed Care contract functions including contract negotiations, contract language and rate analysis, maintenance of contractual agreements that require updating through written amendment, acquire updated fee schedules, acquire updated DRGs/weights, and acquire other data related to contract maintenance. The Network Accounts Manager Sr will also be responsible for distribution of data and provide other support as encountered in the Managed Care department. Specifically, the duties include but are not limited to: Contract negotiation with health insurance organizations and other organizations that take financial responsibility for payment of hospital and practitioner services. Redline contract agreements to ensure State and Federal insurance regulation compliance as well as governmental regulatory compliance. The Network Accounts Manager Sr will be cross trained in Hospital, Practitioner and Transplant negotiations and contracting. The Network Accounts Manager Sr will be the liaison between the corporation and Payor in order to resolve issues associated with revenue cycle, utilization management, patient access, and other operations. The Network Accounts Manager Sr may also function in the capacity of project manager when certain Managed Care initiatives require implementation across the organization such as pay for performance initiatives, in-services with payors, etc. The Senior Contract Administrator will be involved in various meetings as a subject matter expert involving managed care. Responsible for performing job duties in accordance with mission, vision and values of Tampa General Hospital.

Qualifications

• Bachelor's Degree.
• At least three (5) years of relevant experience in the field. Knowledge of Microsoft Excel, Word, and Access database. Strong analytical, problem solving, and communication skills.
• Ability to work independently and bring projects to conclusion.
• Ability to lead project teams to reach defined goals.