At Alliance Radiology, our team members focus on transforming the patient experience and delivering exceptional quality care. Alliance Radiology has rapidly grown over the past 30 years by providing radiology service line solutions, outpatient center management services, and mobile radiology solutions (Per Diem, PT, and FT MRI, PET/CT, CT).
The Senior Manager of Managed Care is responsible for overall administration of all documentation related to Managed Care contracts, Government Enrollment and Physician Credentialing, Reviews all new or amended payor contracts completed by the Managed Care contracts department for acceptable terms prior to delivery to General Counsel. Ensures all contract guidelines are verified and followed. Responsible for Government Enrollment and Physician Credentialing group oversight through Supervisor/ Manager.
Specific duties include, but are not limited to:
- Manage and direct contracts staff responsible for preparation, review and administration of contracts related documentation. Responsible for the schedule and coordination of contractual documentation for review with internal departments, develop draft changes to contracts and prepare necessary documents for effective presentation to senior management. Process, prepare and issue announcement and launch for signed and executed agreements.
- Assists in market research specific to; new modalities, payor trends, reimbursement analysis and methodologies, managed care forecasting, Also the Medicare/Medicaid changes for enrollment utilizing an outside specialty source.
- Organizes/attends conference calls with regional teams for issues, new sites, joint ventures, RAD 360 opportunities, and acquisitions with regard to Medicare/Medicaid and Payor discussions. Resolves payor issues.
- Responsible for coordinating any changes to the Managed Care/Government Enrollment and Physician Credentialing database.
- Negotiates rates and language for managed care contracts with all managed care company structures.
- Interfaces with Scheduling and Billing departments and payors regarding AIN and retail sites, Medicare issues, regulatory compliance and reimbursement issues. Resolves payor issues.
- Manages the ACR managed care application process for all retail business sites.
- Bachelor’s degree from an accredited college or university or six (6) to eight (8) years of equivalent work experience required.
- Four (4) to six (6) years experience in managed care environment required.
- 5 years management experience preferred.
- Experience with sales, internal customer team members, executive staff and legal and contracting teams. Demonstrated drafting skills and identifying the parties’ contractual obligations. Possess analytical and verbal communication skills. Ability to assess contract compliance working with legal Counsel. Demonstrate ability to work on concurrent tasks while effectively organizing, prioritizing and coordinating work assignments.
- Familiar with Medicare/aid contracting, IDTF, credentialing preferred.
A division of Alliance HealthCare Services, we are an equal opportunity employer and we believe in strength through diversity. All qualified applicants will receive consideration for employment without regard to, among other things, age, race, religion, color, national origin, sex, sexual orientation, gender identity & expression, status as a protected veteran, or disability.