Top Managed Care Executive jobs in Wisconsin

Top Managed Care Executive plans and directs all aspects of an organization's managed care function. Responsible for directing and implementing managed care systems for healthcare facilities. Being a Top Managed Care Executive requires a bachelor's degree. Typically reports to a top management. The Top Managed Care Executive manages a departmental function within a broader corporate function. Develops major goals to support broad functional objectives. Approves policies developed within various sub-functions and departments. To be a Top Managed Care Executive typically requires 8+ years of managerial experience. Comprehensive knowledge of the overall departmental function. (Copyright 2024 Salary.com)

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MANAGED CARE CONTRACT COORD, FCH - MANAGED CARE
  • Froedtert Health
  • Menomonee Falls, WI CONTRACTOR
  • Discover. Achieve. Succeed. #BeHere

    Location: US:WI:MENOMONEE FALLS at our WOODLAND PRIME 400 facility.

    This job is HYBRID.

    FTE: 1.000000

    Shift: 1st shift 8 am to 4:30 pm onsite Tuesday and Wednesday then work from home Monday Thursday, and Friday.

    Job Summary:

    The Managed Care Contract Coordinator acts as a liaison with managed care organizations (e.g., networks, insurers) and with internal customers, such as Patient Financial Services and Quality, to resolve issues related to reimbursement and managed care requirements. Other duties as assigned.

    The Managed Care Contract Coordinator manages the contracts with the insurance payers for the entire FH system. The position:

    • Works as a liaison by presenting contract summaries to the organization to explain contract reimbursement and contract terms to internal constituents.
    • Consults with clinical and business units to assess if contract terms are being followed.
    • Identifies new contracting opportunities for strategic growth.
    • Assists to negotiate reimbursement and language of payer contracts.
    • Addresses operational issues and provides contract language to support appeals to the Payer.
    • Establishes productive personal relationships with payer representatives and internal clinical/business staff.
    • Ensure all documents associated with the negotiation payer agreement are in appropriate system accurately and performs audits on a regular basis to ensure accuracy.
    • Other duties as assigned.

    EXPERIENCE DESCRIPTION:

    Three to five years of experience in a Health Care setting in either the payer or provider environment.

    Demonstrated ability in resolving complex issues is required.

    EDUCATION DESCRIPTION:

    Bachelor's degree in Business, Finance, Accounting or related field is required. In lieu of degree will consider 7 years of health care experience.

    SPECIAL SKILLS DESCRIPTION:

    Knowledge of managed care principles and the insurance industry is required.

    Ability to take initiative and exercise independent decision making.

    Strong Communication Skills And Strong Organizational Skills Are Essential.

    Project management experience and strong PC skills including database management, spreadsheets and SharePoint editor.

    LICENSURE DESCRIPTION:

    Managed care certification is preferred.

    Perks & Benefits At Froedtert Health

    Froedtert Health Offers a variety of perks & benefits to staff, depending on your role you may be eligible for the following:

    • Paid time off
    • Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities
    • Academic Partnership with the Medical College of Wisconsin
    • Referral bonuses
    • Retirement plan - 403b
    • Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics
    • Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available

    The Froedtert & the Medical College of Wisconsin regional health network is a partnership between Froedtert Health and the Medical College of Wisconsin supporting a shared mission of patient care, innovation, medical research and education. Our health network operates eastern Wisconsin's only academic medical center and adult Level I Trauma center engaged in thousands of clinical trials and studies. The Froedtert & MCW health network, which includes ten hospitals, nearly 2,000 physicians and more than 45 health centers and clinics draw patients from throughout the Midwest and the nation.

    We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce. We welcome protected veterans to share their priority consideration status with us at 262-439-1961. We maintain a drug-free workplace and perform pre-employment substance abuse testing. During your application and interview process, if you have a need that requires an accommodation, please contact us at 262-439-1961. We will attempt to fulfill all reasonable accommodation requests.
  • 6 Days Ago

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Managed Care Coordinator
  • Family Health Center of M
  • Neillsville, WI FULL_TIME
  • The Managed Care Coordinator completes insurance requirements and provides case management as needed for services performed in various patient seeing settings. The individual obtains and provides insu...
  • 2 Days Ago

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Managed Care Coordinator
  • Family Health Center of M
  • Medford, WI FULL_TIME
  • The Managed Care Coordinator completes insurance requirements and provides case management as needed for services performed in various patient seeing settings. The individual obtains and provides insu...
  • 9 Days Ago

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Managed Care Coordinator
  • Family Health Center of Marshfield, Inc.
  • Neillsville, WI FULL_TIME
  • The Managed Care Coordinator completes insurance requirements and provides case management as needed for services performed in various patient seeing settings. The individual obtains and provides insu...
  • 9 Days Ago

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Managed Care Coordinator
  • Family Health Center of Marshfield, Inc.
  • Medford, WI PART_TIME
  • The Managed Care Coordinator completes insurance requirements and provides case management as needed for services performed in various patient seeing settings. The individual obtains and provides insu...
  • 16 Days Ago

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RN Care Manager
  • Managed Health Services Wisconsin
  • Carlton, WI FULL_TIME
  • You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offeri...
  • 3 Days Ago

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Director OF Clinical Services (Center-Based)
  • Centria Autism
  • Phoenix, AZ
  • Centria Autism is the largest provider of Applied Behavior Analysis (ABA) for children with Autism Spectrum Disorder (AS...
  • 6/12/2024 12:00:00 AM

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Health Systems Engineer
  • Sanford Health
  • Sioux Falls, SD
  • Careers With Purpose Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the Unite...
  • 6/12/2024 12:00:00 AM

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Health Systems Engineer
  • Sanford Health
  • Fargo, ND
  • Careers With Purpose Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the Unite...
  • 6/12/2024 12:00:00 AM

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Chief Operating & Experience Officer, Health Plan
  • Sanford Health
  • Sioux Falls, SD
  • Careers With Purpose Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the Unite...
  • 6/12/2024 12:00:00 AM

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Accreditation Specialist (Clinical)
  • Sanford Health
  • Fargo, ND
  • Careers With Purpose Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the Unite...
  • 6/12/2024 12:00:00 AM

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Director, Denial Management & Prevention - Relocation Offered!
  • MEDSTAR HEALTH
  • Baltimore, MD
  • General Summary of Position The Director, Denial Management & Prevention is responsible for directing and administering ...
  • 6/12/2024 12:00:00 AM

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Assistant Manager of Nursing Medical Surgical - Relocation Offered!
  • MEDSTAR HEALTH
  • Clinton, MD
  • General Summary of Position The Assistant Director of Nursing is a member of MedStar Health entity-based Division of Nur...
  • 6/12/2024 12:00:00 AM

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Assistant Manager of Nursing Float Pool - Relocation Offered!
  • MEDSTAR HEALTH
  • Clinton, MD
  • General Summary of Position The Assistant Director of Nursing is a member of MedStar Health entity-based Division of Nur...
  • 6/12/2024 12:00:00 AM

Wisconsin is bordered by the Montreal River; Lake Superior and Michigan to the north; by Lake Michigan to the east; by Illinois to the south; and by Iowa to the southwest and Minnesota to the northwest. A border dispute with Michigan was settled by two cases, both Wisconsin v. Michigan, in 1934 and 1935. The state's boundaries include the Mississippi River and St. Croix River in the west, and the Menominee River in the northeast. With its location between the Great Lakes and the Mississippi River, Wisconsin is home to a wide variety of geographical features. The state is divided into five dist...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Top Managed Care Executive jobs
$209,487 to $371,662

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