Managed Care Manager - Miami, United States - Borinquen Health Care Center

    Borinquen Health Care Center
    Borinquen Health Care Center Miami, United States

    1 month ago

    Default job background
    Full time
    Description
    Borinquen Medical Centers is based in Miami, FL and is seeking to hire a full-time Managed Care Manager.

    The Managed Care Manager is responsible for assisting the Executive Team in negotiating, maintenance, problem resolution and internal coordination of assigned managed care contracts and proposals.

    Works with the CEO to manage the contract process.

    Acts as a service representative for internal clients and payors, scheduling in-services as needed and works to provide information to Borinquen Medical Centers to enable them to operationalize their managed care agreements.

    Responsible for maintaining contracting files, credentialing with health plans and coordinates with HR and Finance to ensure providers are properly credentialed and uploaded in all systems.

    Responsible to properly support UDS managed care tables and reporting capabilities. Supports the management team by providing input into the strategic planning process. Key staff to support provider relations for Borinquen Medical Centers and all health plans or MSO's.