Children's Health (Dallas) is seeking a Registered Nurse (RN) PCU - Progressive Care Unit for a nursing job in Dallas, Texas.
Job Title & Specialty Area: Program Manager, Managed Care
Department: Managed Care
Job Type: This is a remote position with regular on-site meetings (i.e. "hybrid").
Why Children’s Health?
At Children's Health, our mission is to Make Life Better for Children, and we recognize that their health plays a crucial role in achieving this goal. Through our cutting-edge treatments and affiliation with UT Southwestern, we strive to deliver an extraordinary patient and family experience, ensuring that every moment, big or small, contributes to their overall well-being. Our dedication to promoting children's health extends beyond our organization and encompasses the broader community. Together, we can make a significant difference in the lives of children and contribute to a brighter and healthier future for all.
Summary:
Facilitate analysis, preparation, and scheduling for joint operation committee meetings with managed care payors ensuring timely resolution and escalation to leadership as needed. Supports Managed Care Contracting and Revenue Cycle by gathering, analyzing, and sharing data on managed care payors' compliance with payment provisions of their contracts with CHST providers and developing and implementing strategies for improving payer contract compliance, resulting in increased net revenue.
Manages or provides support to special programs, including but not limited to, cost-share plans, out-of-state Medicaid and the CHST international patient process, managing the financial requirements and ensuring adequate payments prior to services being rendered. Identifies payor updates and requirements and provides education to impacted departments. Analyzes payor trends for assigned CHST programs/ service lines to identify root cause. Manages and provides MC Contracting support for CHST programs/service lines and oversees payor contract adherence, providing comprehensive examination and process to ensure payors comply with all contractual obligations. Utilizes applications and tools to support performance management reporting including providing an overview of key performance indicators to internal stakeholders.
Responsibilities:
This is a full-time position.
How You’ll Be Successful:
WORK EXPERIENCE
EDUCATION
A Place Where You Belong
We put our people first. We welcome, value, and respect the beliefs, identities and experiences of our patients and colleagues. We are committed to delivering culturally effective care, creating meaningful partnerships in the communities we serve, and equipping and developing our team members to make Children’s Health a place where everyone can contribute.
Holistic Benefits – How We’ll Care for You:
· Employee portion of medical plan premiums are covered after 3 years.
· 4%-10% employee savings plan match based on tenure
· Paid Parental Leave (up to 12 weeks)
· Caregiver Leave
· Adoption and surrogacy reimbursement
As an equal opportunity employer, Children's Health does not discriminate against employees or applicants because of race, color, religion, sex, gender identity and expression, sexual orientation, age, national origin, veteran or military status, disability, or genetic information or any other Federal or State legally-protected status or class. This applies to all aspects of the employer-employee relationship including but not limited to recruitment, hiring, promotion, transfer pay, training, discipline, workforce adjustments, termination, employee benefits, and any other employment-related activity.
Children's Health (Dallas) Job ID #19602. Posted job title: Program Manager, Managed Care
At Children's Health, our mission is to Make Life Better for Children for 110 years, and generation to come. We recognize that their health plays a crucial role in achieving this goal. Through our cutting-edge treatments and affiliation with UT Southwestern, we strive to deliver an extraordinary patient and family experience, ensuring that every moment, big or small, contributes to their overall well-being.
Our dedication to promoting children's health extends beyond our organization and encompasses the broader community.
Together, we can make a significant difference in the lives of children and contribute to a brighter and healthier future for all.
Published: a week ago