Details
Department: Managed Care Operations
Schedule: Full-Time, 8-hour day shift, Monday-Friday, Remote
Facility: Ascension
Benefits
Paid time off (PTO)
Various health insurance options & wellness plans
Retirement benefits including employer match plans
Long-term & short-term disability
Employee assistance programs (EAP)
Parental leave & adoption assistance
Tuition reimbursement
Ways to give back to your community
Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance and salary range at the time of the offer.
Responsibilities
Leads the design, implementation, and optimization of managed care operational processes and data management strategies. Participates in system-wide strategic planning and governance, develops policies and procedures to drive execution of managed care initiatives, financial and operational performance.
Develop and implement standardized operational and data management practices that support the full lifecycle of managed care, including contract implementation, maintenance, and performance tracking.
Develops and implements strategic and operational goals and objectives. Ensures policies and procedures are current and in compliance with applicable regulations and standards. Makes recommendations based on changes and trends in the area of managed care, reimbursement and applicable state and federal regulatory environment.
Oversee the integrity and accuracy of managed care data across systems, partnering with analytics, IT, and finance teams to ensure consistent, reliable reporting and insights.
Oversee systems administration and day-to-day operations, ensuring reliability, efficiency, and alignment with organizational needs.
Lead efforts to capture business needs, translate them into system requirements, and ensure alignment with organizational goals, while partnering with key stakeholders to define CLM analytics standards, frameworks, and governance.
Analyzes and interprets system-wide analytical information and provides system and local level leadership with insightful observations and action plans to address trends.
Develop and implement controls and monitoring mechanisms to maintain data quality and operational compliance with business requirements and internal standards.
Create dashboards, reporting tools, and data visualizations that promote transparency into contract performance, operational efficiency, and financial impact.
Serve as a key operational partner in enterprise initiatives involving contract management, contract modeling, and managed care reporting infrastructure.
Collaborate with executive leadership to define strategic priorities, clarify scope of work, and ensure alignment with organizational objectives. Communicate operational updates and key initiatives.
Drive issue resolution by proactively identifying and mitigating risks that may impact success in the assigned area.
Reinforces the preparation and development process of presentations, financial reports, and operational metrics to enhance data-driven decision-making.
Actively pursue continuing contract education opportunities to remain abreast of industry trends and changes to managed care contracting, payer relations, laws and regulations.
Requirements
Education:
High School diploma equivalency with 5 years of applicable cumulative job specific experience required, with 2 of those years being in leadership/management OR Associate's degree/Bachelor's degree with 3 years of applicable cumulative job specific experience required, with 2 of those years being in leadership/management.
Additional Preferences
LI-Remote
Why Join Our Team
Ascension associates are key to our commitment of transforming healthcare and providing care to all, especially those most in need. Join us and help us drive impact through reimagining how we can deliver a people-centered healthcare experience and creating the solutions to do it. Explore career opportunities across our ministry locations and within our corporate headquarters.
Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.
Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.
Equal Employment Opportunity Employer
Ascension will provide equal employment opportunities (EEO) to all associates and applicants for employment regardless of race, color, religion, national origin, citizenship, gender, sexual orientation, gender identification or expression, age, disability, marital status, amnesty, genetic information, carrier status or any other legally protected status or status as a covered veteran in accordance with applicable federal, state and local laws.
For further information, view the EEO Know Your Rights (English) (https://www.eeoc.gov/sites/default/files/2022-10/22-088\EEOC\KnowYourRights\10\20.pdf) poster or EEO Know Your Rights (Spanish) (https://www.eeoc.gov/sites/default/files/2022-10/22-088\EEOC\KnowYourRightsSp\10\20.pdf) poster.
As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.
Pay Non-Discrimination Notice (https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp\%20English\formattedESQA508c.pdf)
Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.
E-Verify Statement
This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information.
E-Verify (https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify\Participation\Poster_ES.pdf)
