If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet.
The Business Development and Managed Care Department at UHealth has an exciting opportunity for a Senior Healthcare Contracting Manager. This position is located in the UM Medical Campus, Health District.
SUMMARY
The Senior Healthcare Contracting Manager oversees the Business Development and Managed Care Department, and supervises the architecture and quality control of all rate schedules and models used for analyzing and reporting projected and current net revenue for managed care contracts and new business ventures. The incumbent in this position works closely with department leadership to recommend contract rates and methodologies that meet the strategic and financial goals of Managed Care contracting and business development for the UHealth System
JOB FUNCTIONS
Builds service line definitions and payment rules.
Validates supporting tables and fee schedules.
Authorizes and monitors expected payment calculation and communicates applicable rate schedule to appropriate parties.
Rebuilds existing rate schedules to incorporate reimbursement structure and rate changes being negotiated.
Tests new models and validates calculation of new expected reimbursement.
Summarizes financial impact and communicates recommendations to contracting team.
Oversees the training, workflow, and work product of junior staff members.
Manages and ensures the accuracy of rate schedules and models constructed in modeling systems, as well as teamwork products.
Influences and provides input to forecasting and planning activities.
Scopes out projects, develops process flows, and coordinates team activities, departmental meetings, and training and skills development.
Establishes and continuously assesses the effectiveness of the internal controls within the unit and compliance with University policies and procedures.
Ensures employees are trained on controls within the function and on University policy and procedures.
Any appropriate combination of relevant education, experience and/or certifications may be considered.
This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.
CORE QUALIFICATIONS
Education:
Bachelor's degree in relevant field
Experience:
Minimum 5 years of relevant experience
Knowledge, Skills and Attitudes
Knowledge of business and management principles.
Ability to direct, manage, implement, and evaluate department operations.
Ability to establish department goals and objectives that support the strategic plan.
Ability to effectively plan, delegate and/or supervise the work of others.
Ability to lead, motivate, develop and train others.
#LI-CM1
The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.
UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.
The University of Miami is an Equal Opportunity Employer - Females/Minorities/Protected Veterans/Individuals with Disabilities are encouraged to apply. Applicants and employees are protected from discrimination based on certain categories protected by Federal law. Click here for additional information.
