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Managed Care Contracting & Payor Relations Manager-Northbrook, Illinois

Company Name:
Autism Home Support
Position Type:
Full-time
The Managed Care Contracting and Payor Relations Manager supports the Operations of Autism Home Support Services (AHSS), by performing activities involved in insurance management, contacting physician groups, managed care organizations,and hospital systems. The position has responsibility for identifying and targeting strategic and transactional relationships with managed care organizations and insurance payers with the goal to have AHSS as in-network provider for mutually beneificial relationships. Responsible to maintain the database of organizations;negotiate contracts, continued relations with contracted managed care and HMO groups. Working with our finance organization, the Managed Care and Contracting Relations Manager negotiates economically sustainable rates and provides insurance partners with analysis and data to support strong relationships. This position works closely with the New Markets Manager, Finance Director, the Director of Insurance & Billing and, as needed, other members of the organization. Provides critical support in new markets by identifying resources and organizations to assure reimbursement success.
RESPONSIBILITIES:
Educates AHSS on managed care, contracting and related protocols, policies, and procedures.
Negotiates terms of contractual arrangements with physician groups, hospital systems, IPA, and managed healthcare firms within established limites. Negotiates contract renewals.
Participates in team meetings to review progress to budget goals and ensures issues are resolved. Functions as an

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