Managed Care Manager
Job Type
Full-time
Description

Title: Managed Care Manager 

Base Salary Range: $70,000 - $84,014 plus benefits

FTE: Full-time, Exempt


Company intro: South Central Family Health Center (SCFHC) is a primary health care clinic that has been committed to providing quality health care for uninsured families and individuals for more than 37 years. Seeks passionate individuals to join our team.


Our Mission: The Mission of South Central Family Health Center is to improve the quality of life for the diverse Community of inner city Los Angeles by providing affordable and comprehensive health care and education in a welcoming and multi-cultural environment. 

To lead the way in health care in South Los Angeles, as the premier provider and employer of choice offering comprehensive, high quality, affordable, efficient and culturally responsive services.


Responsibilities:  The Managed Care Manager will analyze, negotiate, and implement contracts with all third-party payers in an effort to support and further the company in its goals for growth. The Managed Care Manager will support and provide an integrated infrastructure for all existing and future programs and services. Serves as the organization’s expert in managed care, bundling, and reimbursement. Provides assistance to patients regarding health insurance and benefits to elder  people, disable Medicare beneficiaries, and their family, partners, and caregivers. 

  • Coordinates and facilitates the enrollment of patients to local, state and county  programs. 
  • Work with Insurance  companies and other payors to resolve accounts efficiently.
  • Uses health education department strategic plan, explore, plan/conduct, manage, coordinate, and evaluate new and existing patient health education programs and community outreach activities (including patient classes) for SCFHC patient and community members; participating in their delivery as appropriate (ensuring productivity levels are met and are cost effective)
  • In conjunction with COO and CMO, sets educational standards and protocols and develop uniform health education materials for use at clinic and by all health educators
  • Responsible for selecting, orienting, training, assigning, scheduling, coaching, counseling, and disciplining  employees; communicating job expectations; planning, monitoring, appraising job contributions; recommending compensation actions; adhering to policies and procedures
  • In conjunction with Development Director, ensures program requirements and funding reports are fulfilled per grant and contract stipulations
  • Conducts periodic and ongoing health education needs assessments of SCFHC community (including agencies, community leaders, advocates, patients, and community members)
  • Supervises the work performance and training needs of the existing health education and outreach staff.
  • Assists with supervision and evaluation of health educator and outreach interns and volunteers
  • Interfaces with community based organizations and county, state, and federal agencies concerning trends, resources and patient information materials available to support the Health Education functions
  • Develops, implements and monitors the budget for health education programming in conjunction with COO and CFO
Requirements

  

Top benefits or perks: As a team member at South Central Family Health Center, you’ll enjoy competitive wages and generous benefits:

  • Benefits: Health care, dental, life insurance
  • 403 (b) Retirement plan
  • Education Reimbursement
  • Career development: Entry-level employees have opportunities to work in management, HR or other areas of the company 

Qualifications:

  • BA Degree in health education or related field required
  • MPH, MPA, RN, or other related field of study preferred
  • Must have minimum 3 – 5 years prior experience in developing and managing programs
  • Minimum 3 – 5 years previous supervisory experience required
  • Experience providing health education and counseling services to community member/patients using formal and informal education techniques