Managed Care Director
Managed Care Director directs and oversees the team responsible for reviewing and negotiating managed care contracts. Reviews utilization reports and evaluates financial impacts to support contract negotiations and maintain care quality. Being a Managed Care Director identifies patterns in service use and recommends strategies to improve efficiency and reduce expenses. Manages relationships with payers, monitors the contract performance, and proposes strategies for improving operations and optimizing revenue streams. Additionally, Managed Care Director ensures that patient care delivered to members meets quality standards and complies with applicable regulations. Requires a bachelor's degree. Typically reports to senior management. The Managed Care Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. To be a Managed Care Director typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function.
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