Manager of Managed Care in Franklin, TN at Acadia Healthcare

Date Posted: 1/3/2021

Job Snapshot

Job Description

Overview

Our Team:

We are improving the lives we touch. We need passionate, talented people working together who share our desire to create a world-class organization that sets the standard of excellence in the treatment of speciality behavioral health and addiction disorders. Acadia Healthcare is headquartered in Franklin, TN and is a leading provider of behavioral healthcare services in the nation. Our organization values input from employees and fosters collaboration to create a team oriented service delivery system.

Our Benefits: 

  • Medical, dental, and vision insurance
  • Acadia Healthcare 401(k) plan
  • Paid vacation and sick time
  • Opportunity for growth that is second to none in the industry 

Your Job as a Manager of Managed Care: 

The Manager of Managed Care is responsible for assessing the managed care contracting needs of each assigned facility and managed care readiness for key healthcare initiatives. Provides support and guidance to facilities in the areas of managed care contracting, managed care relationships and developing an infrastructure to support managed care business, payor mix, and contract operations.  Assists in the development of a Division’s managed care contracting initiatives to include preparing facilities for Value Based Contracting.  Develops training materials and provides on-site support to facility staff, when needed.  Evaluates reimbursement rates and reimbursement methodology to result in a positive impact to facility’s net revenue growth.

Your Responsibilities a Manager of Managed Care:

  • Assists facilities in managed care contracting and revenue enhancement strategies for their area.
  • Uses data to determine areas where rates can be potentially improved.
  • Review rates and renewal dates by payer and facility to ensure facilities are negotiating rates timely and that rate requests are appropriate. Owns negotiation, when appropriate.
  • Provides guidance to facilities regarding development of managed care relationships and rates.
  • Assists facilities with ensuring managed care contracts are acceptable according to organization’s required standards, and is responsible for pre-screening managed care contract terms prior to uploading to contract system for legal review. Assists in execution and implementation of contract changes.
  • Negotiates contracts for startup facilities and facilities who change from a self-pay model to a more diversified business model to include managed care.
  • Provides guidance on payor-related documents and forms needed for network participation and advises on making changes to network status including but not limited to: services offered, locations, and participating products.
  • Assists facilities with issues with major payors such as contract disputes and denials.
  • Work with facilities to monitor the impact of specific managed care strategies and contracts. Evaluates opportunities to grow net revenue by contracting and/or terminating contracts with payors.
  • Assist business development staff to ensure volume growth with key payors and achieve a balanced payor mix.
  • Provide ongoing training to facility staff on-site or via regularly scheduled conference calls.
  • Works with Vice President of Managed Care to maintain current knowledge of managed care trends and changes and ensure facilities are prepared for changes and remain compliant.
  • Works with division leadership and Corporate UM/Intake/Business Office staff to ensure payer related challenges and opportunities are addressed collaboratively.

Your Skills and

Job Requirements

as a Manager of Managed Care:

  • Bachelor’s degree in business or healthcare related field.
  • Minimum 5 years’ contract experience in a health care facility/system or managed care organization. Previous behavioral healthcare experience preferred.
  • Knowledge of laws, regulations and rules related to healthcare and managed care.
  • Knowledge of major payors, reimbursement, and value based contracting models.
  • Effective and accurate oral and written communication skills. Ability to communicate interdepartmentally to include Business Office, UM, Clinical, Finance Operations, Compliance, Legal, and Senior Leaders.