Thank you for considering a career at Roper St. Francis Healthcare!

Scheduled Weekly Hours:

40

Work Shift:

Days (United States of America)

Location: Roper St. Francis Office Park, Ladson, SC

Shift: 8:00am-5:00pm

Primary Function/General Purpose of Position

Responsible for managed care initiatives & performance, including contracting, reporting, and operations, related to hospitals, physicians (employed and contracted), Home Health, Hospice, Ambulatory Surgery Center(s) and other hospital/physician joint ventures. Manages the functions of the Credentialing/Provider Enrollment Team. Works with RSFH Managed Care leadership to develop managed care strategy then implements the activities towards those objectives. Assists in the development, implementation, and maintenance of contracting policies and procedures, processes, and measurement tools.

Essential Job Functions

• Negotiate, evaluate, and provide ongoing support of managed care contracting activities for:

• a. employed and contracted physicians

• b. system Hospice agency

• c. system Home Health agency

• d. ambulatory Surgery centers

• e. system hospitals

• Manage the Provider Credentialing/Enrollment process. Assists with the education of RSFH personnel and entities on managed care and related topics.

• Assist in the coordination of contracting/operational activities and develop and implement performance improvement action plans as appropriate. Develop and maintain cooperative working relationships with internal and external constituents to effectively evaluate and assess overall impact of contracting initiatives. Develop and maintain tools and reports to facilitate decision-making processes related to managed care contracting Activities shall include the identification and acquisition of relevant data to support reporting needs and to manage RSFH's payor relationships, including the development of contract modeling tools to simulate the impact of a contract(s).

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.

Licensing/Certification

• N/A

Education

• Bachelor’s degree (required)

• MHA/MBA (preferred)

Work Experience

• Three years of experience in managed care, including contract negotiation, financial/operation analysis credentialing/enrollment and legal review desired (required)

• Experience in/with integrated healthcare providers recommended (preferred)

• Understanding of issues from payor perspective useful (preferred)

Training

• N/A

Language

• N/A

Patient Population

The following must be included in all position descriptions that involve direct or indirect patient care. _  This is a Joint Commission requirement.  Also, select the age of the patient population served:_

    X     Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients served on his or her assigned unit.

         Demonstrates knowledge of the principles of growth and development of the life span and possesses the ability to assess data reflective of the patient's status and interprets the appropriate information needed to identify each patient's requirements relative to his or her age, specific needs and to provide the care needed as described in departmental policies and procedures.​

         Neonates (0-4 weeks)

         Infant (1-12 months)

         Pediatrics (1-12 years)

         Adolescents (13-17 years)

         Adults (18-64 years)

         Geriatrics (65 years and older)

         Not applicable to this position

Working Conditions/Physical Requirements

Frequent sitting. Frequently requires long periods of working at a computer. Intermittent walking, standing, stooping, bending. May require lifting or moving items up to 25 lbs. Frequent use of finger/hand dexterity. Constant talking or hearing. Corrected hearing and vision to normal range. No exposure to blood, body fluids or tissue. Possible exposure to infectious materials, communicable diseases and/or other conditions common to a healthcare environment. Normal office environment. Requires work under stressful conditions, deadlines, and/or irregular hours. Ability to read and comprehend. Requires frequent verbal and written communications in English to employees, corporate staff, physicians, clients, and vendors.

Skills

Hard/Tech/Clinical Skills :

• Management principles including financial planning and analysis, reimbursement, contract negotiations, problem solving, and human resource development.

• Maintains knowledge of current trends and developments in the managed care field.

• Fluent in system-wide PC applications Excel, Word, and PowerPoint.

Soft/Interpersonal Skills:

• Ability to work under stressful conditions, deadlines, and/or irregular hours

Roper St. Francis Healthcare is an equal opportunity employer.

Many of our opportunities reward* your hard work with:

• Comprehensive, affordable medical, dental and vision plans

• Prescription drug coverage

• Flexible spending accounts

• Life insurance w/AD&D

• Employer contributions to retirement savings plan when eligible

• Paid time off

• Educational Assistance

• And much more

*Benefits offerings vary according to employment status.

Department:

SS Managed Care - Contracting - Roper St Francis Healthcare

It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a). Accordingly, all applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@RSFH.com .