Sr. Manager, Managed Care

Pediatrix Medical Group, Inc., (symbol: "PDX" on the NYSE), the nation's largest provider of neonatal and maternal-fetal physician services, has an exciting opportunity available for a Sr. Manager, Managed Care in our Corporate Office in Sunrise (near Sawgrass Mills).

 

The primary objective is to evaluate, negotiate, and secure agreement to new and existing contracts with health insurance benefit payors.  Responsibilities include but are not limited to: managing the contract assignment process with acquisitions, leading contract negotiations, assisting in the resolution of contract payment issues, analyzing contract performance, and working on strategic and operational partnerships with payors.  Responsible for providing independent support and direction to Regional Managed Care staff.

 

Qualifications

 

A. Education

1.  Required -  Bachelor?s Degree in related field.

2.  Preferred - Master?s Degree in related field.

 

B. Experience

1.  Required - 5 years in health insurance, patient accounting and/or managed care including

payor or provider contracting and supervisory/management experience.  

2. Preferred -  Experience negotiating managed care contracts with third party payors

regarding physician professional service compensation issues; experience with fee schedule, case rate, per diem, and capitation reimbursement; familiar with patient accounting tasks including billing, collections, and reimbursement analysis; strategic planning and marketing experience.

 

C.  Skills/Capability

1. Required - Excellent written and verbal skills; negotiation skills; good time

management and organizational skills to be able to juggle multiple tasks simultaneously; strong professional and interpersonal skills to build and maintain relationships with payor physicians, other health care professionals and hospital management; ability to use software programs such as Excel spreadsheet, Word and data report writers; strong analytical, quantitative and financial skills especially for the development of  health care service compensation proposals; able to work independently and as part of a team; able to set priorities and meet deadlines.

2.  Required -  Comfortable with national travel.