Back to Remote jobs >
All others
Director of Managed Care
@(PACS) Providence Administrative Consulting Services, Inc.
[Hiring] Director of Managed Care @(PACS) Providence Administrative Consulting Services, Inc.
Mar 28, 2025 - (PACS) Providence Administrative Consulting Services, Inc. is hiring a remote Director of Managed Care. 💸 Salary: unspecified. 📍Location: USA.
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.
Role Description
This role involves administering and directing all aspects of managed care, which includes:
- Maintaining relationships with existing managed care plans
- Identifying new managed care payers in states/markets served
- Providing guidance to SNFs to increase referrals
- Leading the development and execution of financial strategy for managed care contracts
Essential Duties
- Directs and performs contract negotiations with managed care payers including rates and terms
- Analyzes existing managed care agreements to determine if rates need to be renegotiated or if contracts need to be terminated
- Monitors existing managed care agreements with SNFs to ensure compliance with plan requirements
- Maintains a database of managed care agreements and SNF access
- Supports and educates regional operation teams and SNFs on new contracts and changes
- Develops and sustains cooperative working relationships with payers
- Acts as a liaison to assist in solving claim issues
- Develops and analyzes payer contract activity when requested
- Reviews managed care PPD trends and communicates findings
- Reviews/Analyzes P&L and participates in Ops calls/meetings
- Coordinates communications between managed care payer and clinical, case management, admissions, business development, and business offices at SNFs
- Monitors credentialing with MNS and updates necessary documents
- Manages and assesses SNF Hospice Agreements and recommends rates
- Completes initial managed care payer agreements credentialing
- Coordinates with Legal Department for VA/SAM registrations
- Manages and establishes VA Agreements for SNFs
Qualifications
- Bachelor’s Degree in business or healthcare related field
- Minimum 5 years of healthcare experience
- Minimum 3 years of managed care experience
- Self-motivated with the ability to manage and prioritize projects
- High degree of accuracy and mental awareness
- Ability to make accurate independent decisions and influence change
- Familiarity with SNF operations, practices, and procedures
- Current knowledge of managed care in multiple states
- Understanding of healthcare issues, trends, and business development opportunities
- Working knowledge of state and federal laws applicable to SNF reimbursement
Benefits
- Health Coverage: Enjoy medical, dental, and vision plans
- PTO and Vacation: Generous paid time off and holidays
- Financial Wellness: Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA)
- Retirement Planning: 401(k) plan with company contributions
- Support When You Need It: Employee Assistance Plan (EAP)
Similar Remote Jobs
More jobs at (PACS) Providence Administrative Consulting Services, Inc.
-
All others unspecified USAMar 21, 2025
-
All others unspecified USAFeb 24, 2025
More All Others jobs
-
All others $160,000 to $200,000 USAMar 31, 2025
-
All others unspecified SingaporeMar 31, 2025
More jobs in USA
-
Project Management unspecified USAMar 31, 2025
-
Software Development competitive base salary with performance-based bonuses USAMar 31, 2025
Kickstart Your Job Search
Need advice to apply?
Join our free
Webinar « 3
Mistakes to Avoid When Looking For A Remote Startup Job (And What To Do Instead) »
Register for free
Unlock 54,680 additional remote jobs, advanced search & email notifications
Get Access Now
Too many emails? Declutter your inbox with Meco
Your home for reading newsletters
Try for free - no card required.
️
| 📍 | Be aware of the location restriction for this remote position: USA |
| ‼ | Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more. |
Back to Remote jobs >
All others
All others
|
Salary
💸
unspecified
|
Remote
Location
USA
|
|
Job Type
full-time
|
Posted
Mar 28, 2025
|
️
| 📍 | Be aware of the location restriction for this remote position: USA |
| ‼ | Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more. |
