Match score not available

Manager, Managed Care Operations

Remote:

Full Remote

Work from:

United States

Offer summary

Qualifications:

Bachelor’s Degree preferred, 4-5 years of Managed Care experience, 2 years of cross functional experience, Proficient in Excel and analytical tools.

Key responsabilities:

Oversee daily operations of Market Access team
Analyze performance metrics for managed care team

NeoGenomics Laboratories Large https://neogenomics.com/

1001 - 5000 Employees

See more NeoGenomics Laboratories offers

Job description

Description

Are you motivated to participate in a dynamic, multi-tasking environment? Do you want to join a company that invests in its employees? Are you seeking a position where you can use your skills while continuing to be challenged and learn? Then we encourage you to dive deeper into this opportunity.

We believe in career development and empowering our employees. Not only do we provide career coaches internally, but we offer many training opportunities to expand your knowledge base! We have highly competitive benefits with a variety of HMO and PPO options. We have company 401k match along with an Employee Stock Purchase Program. We have tuition reimbursement, leadership development, and even start employees off with 16 days of paid time off plus holidays. We offer wellness courses and have highly engaged employee resource groups. Come join the Neo team and be part of our amazing World Class Culture!

NeoGenomics is looking for a Manager, Managed Care Operations based who wants to continue to learn in order to allow our company to grow. This is a remote position.

Now that you know what we're looking for in talent, let us tell you why you'd want to work at NeoGenomics:

As an employer, we promise to provide you with a purpose driven mission in which you have the opportunity to save lives by improving patient care through the exceptional work you perform. Together, we will become the world's leading cancer reference laboratory.

Position Summary:

The Manager of Managed Care Operations is responsible for overseeing the daily operations of the Market Access team. This role focuses on providing actionable insights to support analytics for the team and cross-functional processes within NeoGenomics. The aim is to drive profitable, sustainable growth through contracts with Commercial Payers.

Core Responsibilities:

Monitor, analyze and report on the monthly and quarterly performance of the managed care team and associated payers
Provide technical, analytical and administrative information/data for the Market Access team to negotiate and execute contracts and amendments
Analyze and report on the financial and contractual impacts from all contractual fee schedules as well as the terms and conditions in agreements for all Commercial/Third Party contracted payers, provide actionable insights and recommended course of action
Ensure effective contractual approval, storage and maintenance including the establishment of a renewal trigger system
Partner cross functionally with Strategic Reimbursement, Medical, Billing and Commercial teams to improve reimbursement and profitability by reducing denials, increasing reimbursement, improving processes, etc.
Partner with Credentialing team on all credentialing requests and updates for contracted payers in contract negotiations
Coordinate information for the completion of RFPs and RFIs for proposed agreements and networks established outside of standard commercial payer agreements
Create standard templates and processes for all managed care data requests and support ad hoc data requests
Provide support and insight needed for Monthly/Quarterly Customer reports and/or Business Reviews
Complete administrative responsibilities for all Managed Care Contracts including monthly and quarterly performance reports, preferred lab network reports and applications, partner with all internal contacts on quick and efficient return of requested information
Host monthly and bi-weekly meetings with Billing, Reimbursement, Credentialing and EDI Teams to discuss payer issues with contractual terms and performing site locations to resolve roadblocks and increase revenue
Manage and review all emails received from contracted payers in the NeoMCTeam email inbox as well as personal inbox in regard to Payer updates, disperse all emails to the appropriate internal teams when information provided is applicable to NeoGenomics processes

Experience, Education and Qualifications:

Bachelor’s Degree preferred
4-5 years of Managed Care/Contractual type work experience for a laboratory or other Healthcare provider is required
2 years of cross functional experience working with Commercial, Billing, Cash Posting, Clinical Sales, Strategic Reimbursement and Legal Contracts in regard to specifications from Commercial Contracts
2 years of meeting with upper level executives and contracting directors from internal and external parties
Weekly experience in preparing and confidently presenting data with ease through in person and online meetings with executives and directors, both internally and externally
Must have expert level proficiency in Excel and other analytical tools and databases. Position requires significant Excel report creation, development, and utilization.
Billing system and SalesForce.com familiarity will be necessary on the job. Experience with billing systems and SalesForce.com is a huge plus.
AI and RPA capabilities would be advantageous.
Ability to successfully work cross-functionally with other departments and external customers

All qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status.