Managed Care Contracting Manager

20 hours ago

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Pennant

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Healthcare Insurance • Wellness

Pennant is a company dedicated to providing healthcare services, with a focus on life-changing service, culture, and leadership. They support independent operating subsidiaries that offer home health care, hospice, assisted living, independent living, and memory care. Their mission is to empower local leaders with resources and tools to deliver high-quality care. Pennant operates 103 home health and hospice agencies and 51 senior living communities across several U. S. states, including Arizona, California, and Texas. They emphasize a strong company culture guided by core values that prioritize customer service, accountability, and intelligent risk-taking.

1001 - 5000 employees

Founded 2016

⚕️ Healthcare Insurance

🧘 Wellness

📋 Description

• Support Home Health, Hospice, Private Duty, and Senior Living Facility leaders in managed care contracting and revenue enhancement strategies. • Negotiate managed care payer contract rates and terms and provide guidance for developing managed care relationships. • Conduct managed care education sessions and develop a strategic vision to accelerate the operations results. • Assist in analysis of contract terms and rates and coordinate submissions of amendments and language changes. • Maintain effective relationships with managed care payors and healthcare regulatory agencies. • Monitor industry changes and market trends to protect managed care revenue and present as a subject matter expert. • Teach and train operational leadership on managing their contracts and assist AR team with managed care claims issues.

🎯 Requirements

• Bachelor’s degree in business administration, management or health care administration preferred. • 5 + years’ experience in managed care contracting with a managed care payer or provider organization. • Analytically oriented with the ability to communicate complex financial matters in a concise, professional manner. • Must be knowledgeable about the managed care environment; including Medicare Advantage, Commercial and Managed Medicaid products (HMO, PPO, EPO, POS and Special Needs Plans). • Knowledge of managed care payer contract language and terms, standard requirements and negotiated rate methodology to support contract compliance and analysis. • Strong computer skills (MS Word, MS Outlook & Excel) with Smartsheet knowledge a plus. • Must be able to travel.

🏖️ Benefits

• Health insurance • 401(k) matching • Paid time off • Professional development opportunities