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Manager AMG Contract & Field Ops

Req #:  132544
Facility:  Advocate Medical Group
Department:  Management/Supervisory
City:  Downers Grove
Posting Budget Status:  Day
Shift Type:  Full Time - Permanent
Posting FTE:  1

Purpose:
Responsible for the management and operations of the AMG Contracting Department, Contracted Provider Relations and AMG Field Operations. Leads operations of the contracting department which includes analyzing, negotiating and administering a contracted network with the ability to lead and prioritize constantly changing priorities to the cost effectiveness of AMG. Responsible for developing and implementing strategies to maximize financial performance in AMGs risk based contracts. Utilizes Financial and Utilization data to identify potential performance enhancement opportunities. Works cross functionally with Finance, Medical Management, Operations, Network Compliance, Credentialing and Quality.

 

Position Requirements:

  • Education Required: Bachelor's Degree in Finance, Business Management, Econonmics, Marketing, Health Care Administration or related field
  • Typically requires 5 years of experience in marketing, operations or finance with at least three years of experience in a managed care environment.
  • 1 year of supervisory experience managed care environment.
  • Strong negotiation skills
  • Knowledge of hospital and physician (multi-specialty group, IPA or PHO) operations and services impacted by managed care.
  • Knowledge of the managed care industry
  • Knowledge of various reimbursement methodologies for both physicians and hospitals
  • Strong verbal and written communication skills
  • Strong analytical skills
  • Working knowledge of PC and applications including Excel, PowerPoint, Word, Power BI.
  • Position requires trave
  •  May be exposed to weather and road hazards
  • Exposed to normal office environment.
  • Operates all equipment necessary to perform the job




Accountabilities:

  1. Subject Matter Expert for Advocate Medical Group on Population Health Programs, Accountable Care Index, Risk Adjustment, Utilization Management, Medical Economics
  2. Oversees AMG Managed Care Financial Performance: Monitor financial performance, risk score and utilization of the AMG practices to identify opportunities and then implement corrective action plans in conjunction with Vice Presidents of Operations, Medical Management, Practice Directors and Site Managers.
  3. Manages Payer Relations with regards to contractual payment methodologies and market operational standards. Maintain updates of Advocate Medical Group's vendor grids, insurance information sheets and contractual requirements. Provider Relations acts as a liaison to trouble~shoot payer and network provider contractual issues and provide assistance with interpretation of contractual terms, resolution of billing and payment issues and other contractual issues that arise.
  4. Assures contract compliance with respect to financial terms, operational and legal provisions. Make recommendations and assist medical leadership in the design, implementation and monitoring of contract strategies and objectives. Participate in the due diligence review of contracts for practice acquisitions.
  5. Serves as liaison between AMG, APP, PHOs: Serve as principal relationship manager, monitoring, maintaining and continually improving the relationships among AMG, APP and PHOs
  6. Performs human resources responsibilities for staff which include interviewing and selection of new employees, promotions, staff development, performance evaluations, compensation changes, resolution of employee concenrs

About Advocate Health Care

 

Advocate Health Care, named among the nation’s Top 5 large health systems based on quality by Truven Analytics, is the largest health system in Illinois and one of the largest health care providers in the Midwest. Advocate operates more than 250 sites of care, including 12 hospitals that encompass 11 acute care hospitals, the state’s largest integrated children’s network, the state’s largest emergency and Level I trauma network, one of the area’s largest home health care companies, and the region’s largest medical group. Advocate Health Care has 4 teaching hospitals and is a not-for-profit, mission-based health system affiliated with the Evangelical Lutheran Church in America and the United Church of Christ.

 


Nearest Major Market: Chicago