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Contract Manager - Managed Care

Job Description


Job ID: 1218165
Employment Status: Full-Time
More Information:

BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and mid-Missouri regions. BJC serves patients and their families in urban, suburban and rural communities through its 15 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.

The BJC Managed Care department includes multiple functions such as managed care contracting, financial analysis, systems and operations, value-based care and payment programs, payor and provider relations, and direct to employer solutions.


Overview


Role Purpose

Responsible for the negotiation, implementation and ongoing evaluation of designated managed care arrangements. Make recommendations and take action to ensure and enhance the success of hospital and physician managed care participation.


Responsibilities

  • Provides analysis of financial data, including clinical service line reporting, trend analysis, proformas, and forecasts, and the monitoring of key financial metrics.
  • Coordinates communication and implementation of contract provisions.
  • Negotiates contracts on behalf of BJC hospitals and non-physician providers.
  • Coordinates development of rate proposals and reviews rate analysis.
  • Evaluates contracts and leads negotiations as assigned.

  • Minimum Requirements

     

    Degree

  • Bachelor's Degree
  • - Business/HC Admin/related

     

    Experience

  • 5-10 years
  •  

    Supervisor Experience

  • No Experience

  •  

    Preferred Requirements and Additional Job Information

     

    Experience

  • 10+ years

  • Benefits Statement

    Note: not all benefits apply to all openings

    -  Comprehensive medical, dental, life insurance, and disability plan options
    -  Pension Plan*/403(b) Plan
    -  401(k) plan
    -  Tuition Assistance
    -  Health Care and Dependent Care Reimbursement Accounts
    -  On-Site Fitness Center (depending on location)
    -  Paid Time Off Program for vacation, holiday and sick time

    *Pension does not apply to Memorial Hospital, Memorial Hospital East, Alton Memorial or Parkland Health Center


    Legal Statement

    The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job.

     

    Equal Opportunity Employer