Overview

The Managed Care Operations Lead serves as a resource and advisor, directs all aspects of managed care operations including system wide credentialing with managed care plans, contract performance monitoring and reporting, and contract payment modeling and analysis. Works in collaboration with Chief Financial Officer, consultants Vice President of Finance, Director and Managed Care Specialists to recommend contracting strategies, perform complex contract modeling, and to monitor health plan performance. Acts as a liaison between Managed Care Contracting, Reimbursement, Patient Financial Services, Patient Access and other departments in the hospital in an effort to create seamless operational performance and reimbursement maximization related to managed care contracting and performance monitoring.
Department Description

Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit www.wakemed.org.

EOE

Licensure

Not Applicable
Education

Bachelor's Degree Business Administration Or Healthcare Or Finance Or Related Field Required - And Master's Degree Health Administration Or Business Preferred
Experience

10 Years Managed Care Contracting Required - With 7 Years Managed Care Contracting In Healthcare Required

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