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Home Based Healthcare Contracting Jobs (NOW HIRING)

WakeMed

Director, Managed Care Contracting

Raleigh, NC · On-site

Directs contracting strategy for hospitals, Healthplexes, hospital outpatient departments, Home Health and Rehab divisions. Develops payment models for facility managed care contracts. Oversees ...

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What is the difference between Home Based Healthcare Contracting vs Home Health Aide?

AspectHome Based Healthcare ContractingHome Health Aide
CredentialsVaries; often requires certifications like CPR, health-related trainingTypically requires certification or training specific to caregiving
Work EnvironmentIndependent contracting, flexible hours, often self-employedEmployed by agencies or families, scheduled shifts in clients' homes
Employer & Industry UsageFreelance or agency-based, healthcare industryHome healthcare agencies, healthcare industry
Search & Comparison IntentUnderstanding contracting roles, flexibility, certificationsCaregiving duties, certifications, employment options

Home Based Healthcare Contracting involves independent work with flexible hours and varied certifications, while Home Health Aides are typically employed by agencies to provide direct patient care in clients' homes. Both roles serve the home healthcare industry but differ in employment structure and responsibilities.

What cities are hiring for Home Based Healthcare Contracting jobs? Cities with the most Home Based Healthcare Contracting job openings:
What are the most commonly searched types of Healthcare Contracting jobs? The most popular types of Healthcare Contracting jobs are:
Home Based Healthcare Contracting jobs near you
Director, Managed Care Contracting

Director, Managed Care Contracting

WakeMed

Raleigh, NC • On-site

Full-time

This job post has expired today. Applications are no longer accepted.

WakeMed rating

7.8

Company rating: 7.8 out of 10

Based on 134 frontline employees who took The Breakroom Quiz

131st of 890 rated healthcare providers

Job description

Overview
The Director, Managed Care Contracting is responsible for utilizing business and industry expertise, accepts responsibility for all activities in the Managed Care department applying to and impacting WakeMed facilities' managed care contracts including budgeting, analysis, contract modeling, negotiation meetings and monitoring and reporting of payor contracts' compliance. Directs organizations efforts at building relationships with area managed care plans. Directly manages and develops a portfolio of managed care contracts. Directs contracting strategy for hospitals, Healthplexes, hospital outpatient departments, Home Health and Rehab divisions. Develops payment models for facility managed care contracts. Oversees facility what-if modeling analysis performed in STRATA modeling tool. Oversees the following noncontracting Managed Care responsibilities: hospital contract loading in EPIC, hospital payment variances, facility credentialing. Works with CFO, Vice President of Finance, Finance Directors and financial analysts to analyze feasibility of different payment methodologies/utilization patterns and the impact on WakeMed. Monitors market trends and competitive managed care products to develop strategy recommendations. Works with WakeMed's accountable care organization to coordinate contracting efforts and outcomes beneficial to WakeMed providers. When requested, interfaces with external and third party auditors; prepares and defends contract questions and challenges; maintains quality of work and creates value through knowledge and experience with governmental regulations and processes. Adheres to service and workforce excellence by maintaining knowledge of third-party regulations (CMS, NCDHHS, DOI, etc.) for all payors, including governmental and commercial payors. Oversees problem solving related to contract terms, payment promptness, payor-member issues, and physician-payor relations. Works closely with other Finance teams to ensure reported data is reliable. Plans and organizes activities for personnel to ensure deadlines and goals are met. Supervises and trains staff to improve and maintain the accuracy and timeliness of contacts.
Department Description
Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit www.wakemed.org .
EOE
Licensure
Certified Healthcare Financial Professional Or Certified Public Accountant Or Certified Revenue Cycle Representative Preferred
Education
Bachelor's Degree Business Administration Or Healthcare Management Or Accounting Required - With College Courses Finance Required - And Master's Degree Related Field Preferred
Experience
10 Years Managed Care Contracting Required - And 5 Years Healthcare - Multi-Hospital System Preferred

What WakeMed employees say

Pay

Benefits

Hours and flexibility

Workplace

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About WakeMed

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Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Raleigh, NC, US

Year founded

1961

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