Director of Managed Care Job Listing at Englewood Health in Englewood Cliffs, NJ (Job ID 60436)

Description

Job Summary:
Under the general direction and leadership of the Vice President for Finance; plans, organizes and directs the operational functions of the Medical Center as they relate to managed care. Develops, interprets and implements policies and procedures to create and maintain an effective managed care program with maximum reimbursement rates. This position carries primary administrative responsibilities for the managed care contracting efforts of the Medical Center as well as other corporate entities as needed. Demonstrates the Standards for Service Excellence, so that these standards represent minimum accepted behavior. Plan, direct and coordinate the operations of the Managed Care. Manage staff for optimum performance.

Department: Managed Care
Location: Englewood Cliffs, NJ
Status: Full-Time
Shift:Day
Hours: 9:00am to 5:00pm

Job Essentials: The ideal candidate will meet the following requirements and competencies.

• Three (3) to five (5) years' experience in healthcare, knowledge of payer/insurance Company practices, as well as knowledge of the hospital environment. Experience in the negotiation and management of managed care contracts. Knowledge of state and regulatory HMO guidelines.
• Demonstrated proficiency in the use of a personal computer (windows environment) including but not limited to Word, Excel, Power Point, and Access.
• Must have excellent interpersonal skills and be capable of working with all levels of Medical Center and Medical Staff. Must exhibit relationship skills with contracted partners.
• Must be able to act as a team player, working in concert with other members of administration and the Medical Staff.
• Must possess excellent written, verbal, analytical and communication skills.
• Must be highly organized and capable of performing multiple tasks simultaneously.

Education Requirements:

• Bachelor's Degree required

Englewood Health, one of New Jersey's leading hospitals and healthcare networks, delivers nationally recognized inpatient and outpatient care through its hospital and network of physician practices, urgent care centers, and imaging centers. Englewood Hospital, founded in 1890, consistently earns high marks for clinical excellence and patient safety. It is recognized as a 2022-23 Best Regional Hospital by US News & World Report, holds the Leapfrog Hospital Safety Grade ‘A' (spring 2023), and was named a Leapfrog Top Teaching Hospital (2022). Englewood Hospital is nationally recognized for nursing excellence, earning a fifth consecutive designation by the Magnet Recognition Program in 2021. The Englewood Health Physician Network—a coordinated network of more than 600 office-based and hospital-based providers—offers primary care, specialty care, and urgent care at more than 140 locations in five counties across northern New Jersey. Areas of clinical excellence offered by the health system include cardiac surgery and cardiac care, cancer care, orthopedic surgery, primary care, spine surgery, vascular surgery, and women's health, as well as bloodless medicine and surgery and minimally invasive robotic surgery. Englewood Health's focus on health equity and population health encompasses outreach to underserved communities to enhance individual and public health, prevent disease, support lifelong wellness, reduce the burden of mental health challenges and substance use disorders, and meet the cultural, social, and holistic needs of specific populations. With its high-quality, culturally sensitive inpatient care, outpatient services, and community health and wellness programs, Englewood Health delivers a healthcare experience that puts patients at the center.