Director, Contract Administration, Managed Care
Posted on: August 6, 2022
Director, Contract Administration, Managed Care Galveston, Texas,
United StatesUTMB's 130th AnniversaryOn Oct. 5, 1891, Texas' first
state medical school held its first class in Galveston. Today, 130
years later, the University of Texas Medical Branch is a major
academic health sciences center with four schools, a world-renowned
research enterprise and comprehensive Health System that includes
four hospital campuses and an extensive network of clinics.
www.utmb.edu/130 JOB DESCRIPTION: The primary responsibility of the
Director, Contract Administration, Managed Care is to independently
evaluate, negotiate, and secure agreement to new and existing
contracts with third party payors, including commercial health
plans, managed Medicare health plans, managed Medicaid health plans
and county/hospital district entities. Responsibilities include,
but are not limited to; leading and negotiating third party payor
negotiations, reviewing and reaching agreement with payors on
contract language, establishing contract performance reports,
assisting in collection efforts, and assistance with public policy
initiatives. ESSENTIAL JOB FUNCTIONS:
- Independently negotiates contractual terms and reimbursement
arrangements for health system and faculty group practice.
- Independently prepares and presents strategic, financial and
operational proposals regarding payor agreements.
- Ensures contractual compliance with federal, state, and
- Supervises the coordination and completion of information for
- Mediates managed care issues between managed care
organizations, hospital and clinic personnel.
- Works with County Affairs office on strategic considerations
and operational concerns related to county and hospital district
- Tracks and evaluates managed care as it relates to the local
- Assists with strategic planning and business development.
- Adheres to internal controls as established by department.
- Adheres to internal controls and reporting structure.
- Performs related duties as required.
- Bachelor's degree or equivalent and 5+ years related
- Significant experience negotiating managed care contracts with
third party payors;
- Knowledge of physician professional service compensation models
issues and experience with fee schedule, case rate, per diem, and
capitation reimbursement; familiar with patient accounting tasks
including billing, collections, and reimbursement analysis
KNOWLEDGE / SKILLS / ABILITIES:
- Excellent written and verbal skills; negotiation skills,
computer proficiency (Excel and various software programs, data
- Strong interpersonal and verbal and written communication
- Strong analytical and quantitative skills for the development
of reimbursement proposals.
EQUAL EMPLOYMENT OPPORTUNITY: UTMB Health strives to provide equal
opportunity employment without regard to race, color, religion,
age, national origin, sex, gender, sexual orientation, gender
identity/expression, genetic information, disability, veteran
status, or any other basis protected by institutional policy or by
federal, state or local laws unless such distinction is required by
law. As a VEVRAA Federal Contractor, UTMB Health takes affirmative
action to hire and advance women, minorities, protected veterans
and individuals with disabilities. Compensation
Keywords: UTMB, Galveston , Director, Contract Administration, Managed Care, Executive , Galveston, Texas
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