Email Opening
Title

Manager of Contracting and Credentialing (40 hrs/wk) 

Position Manager of Managed Care Contracting and Credentialing  
Location Corporate Office  
Description

At Advanced Pain Management, we are committed to providing our patients with exceptional care and quality health services. We are always looking for dedicated, hard-working professionals who exemplify our workplace philosophy. Whether you are a medical provider or a professional in another field, Advanced Pain Management can offer you a rewarding career. We offer our employees a working environment that is dedicated to patient care and satisfaction. In addition, we offer our employees competitive pay and benefits and the resources they will need to be successful and enhance their professional growth.

Advanced Pain Management is looking for an experienced Manager of Managed Care Contracting and Credentialing. The position is responsible for all issues involving contracted payers including contract review, credentialing oversight, coordination with billing and authorization concerning contract issues, fee schedule review and rate discussions with third party biller, coordination with APM quality and risk departments to comply with contract obligations.  

 
Position Requirements

Essential Duties include:

  • Responsible for providing leadership, staff development and management of key services in accordance with policies and procedures and current federal, state, and local standards, guidelines and regulations. Manage staff including hiring, training, and development and coaching of direct reports.
  • Creates personnel performance evaluations and initiates personnel actions, such as merit increases, promotions, transfers, disciplinary action, and terminations.
  • Develops organizational strategic operational planning for managed care contracting including staffing, fiscal management, goals and objectives. Responsible for the direct supervision, coaching and development of the Practice Support team.
  • Coordinates with third party billing department on all issues involving third party contracted payers including rates, contracts, audits, etc.
  • Coordinates with the compliance department on all contract issues, regulatory issues, quality issues and other issues under their purview.
  • Develops contractual database to monitor and manage contractual obligations.
  • Participates in payer meetings, visits, audits, etc.
  • Manages existing contracts to optimize reimbursement.
  • Assists in the development of appropriate quality assurance programs and monitors quality control. Incorporates quality improvement and patient satisfaction data into departmental goals.
  • Identifies work related problems with possible solutions and implements appropriate solutions.
  • Creates and manages relationships between providers, facilities and payers related to contracting.
  • Coordinates and communicates payer credentialing requirements as they relate to contracting.
  • Assists in resolution of provider and/or payer issues and disputes.
  • Demonstrates fiscal accountability for department resources and the ability to achieve outcomes within allocated resources.
  • Investigates new opportunities and prepares business plans for the same.
  • Develops operating budgets. Monitors budgets and takes corrective action when necessary, including administrative cost centers. Evaluates and justifies operating needs and purchases. Approves requisitions and purchase orders.
  • Travel to multiple facilities and locations, addressing routine and emergent issues, is required. 
  • All other duties as assigned.

Desirable Candidates will possess:

  • Bachelors Degree. 
  • At least five to seven years of progressive responsibilities in managed care contracting experience is required. At least three years of management experience preferred. 
  • Extensive knowledge in all health care business services areas including reimbursement regulations and managed care contracting practices and procedures, as well as the laws, regulations, and guidelines pertaining to a healthcare company is required.
  • Credentialing & Privileging experience is desired.
  • Excellent organizational skills and excellent communication, both written and verbal.
  • Ability to plan, organize, develop, implement and interpret the programs, goals, objectives, policies and procedures necessary for providing quality care and maintaining a sound operation.
  • Ability to review and project globally for the overall planning of all areas supervised.
  • Experience and ability to work in and/or create a team-oriented, collaborative environment.
  • Ability to develop, implement and monitor multiple projects.
  • Proficient with computer/computer applications, including preparing financial data/reports.
  • Must be flexible and manage change easily with the ability to work positively within a continually changing and diverse environment.
  • Proven analytical, problem-solving, prioritization and task-execution abilities in a high-pressure environment.
  • Requires strong customer service orientation.
  • Ability to successfully and positively interact with physicians is essential
  • Travel required to locations.

 

 
Full-Time/Part-Time Full-Time  
Exempt/Non-Exempt Exempt  
EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.  
About the Organization We are committed to providing our patients with exceptional care and quality health services. We are always looking for dedicated, hard-working professionals who exemplify our workplace philosophy. Whether you are a medical provider or a professional in another field, we can offer you a rewarding career. We offer our employees a working environment that is dedicated to patient care and satisfaction. In addition, we offer our employees competitive pay and benefits and the resources they will need to be successful and enhance their professional growth.

If you are ready to contribute to our team of dedicated professionals improving the lives of patients every day, we are waiting for your application.  
Req Number 100017-00001  

This position is currently not accepting applications.

To search for an open position, please go to http://AdvancedPainManagement.appone.com



WE ALSO RECOMMEND

Other Jobs Within Same Category
Research Coordinator in Greenfield - Corporate, WI
Posted on: 11/10/2017
[Apply Now]


Other Jobs Within 60 Miles
Registered Nurse (PRN) in Milwaukee, WI
Posted on: 7/26/2017
[Apply Now]

Patient Care Coordinator (40 hrs/wk) in Wauwatosa, WI
Posted on: 10/30/2017
[Apply Now]

Radiologic Technologist PRN *No Nights, No Weekends, No Holidays!!! in Wauwatosa, WI
Posted on: 9/14/2017
[Apply Now]

RN Supervisor (40 hours/week) in Milwaukee, WI
Posted on: 9/19/2017
[Apply Now]

Medical Assistant/Licensed Practical Nurse (FT 36 hrs/wk) No Nights, No Weekends, No Holidays!!! in West Bend, WI
Posted on: 9/26/2017
[Apply Now]

See who works here:
 


AppOne.comTM   copyrightŠ1999-2017 HR Services, Inc.
Click here for technical assistance.