Senior Project Manager Business Development

Location:Lee Health Corporate Center -4211 Metro Parkway Fort Myers FL 33916

Department: Business Development and Contracting

Work Type: Full Time

Shift: Shift 1/8:00:00 AM to 4:30:00 PM

Minimum to Midpoint Pay Rate:$30.32 - $39.42 / hour

Summary

This position requires a strong background in managed care payer contracts including negotiation and implementation of payer contracts, provider participation requirements for payer contracts, credentialing requirements, and provider network evaluation and assessment. Ability to understand the market impact of physician participation in payer contracts and knowledge of health insurance plan payment structures is essential. Must closely monitor market trends to identify value and performance of LMHS contracts and to identify opportunities to increase net revenue. Oversees credentialing of LMHS physicians and Lee Physician Hospital Organization (PHO) physicians to ensure status as participating providers in appropriate contracts and to ensure payments by health insurers are made at in-network benefit levels. Requires collaboration with multiple LMHS departments to manage complex and confidential information relating to credentialing. Responsibilities also include devising creative solutions to avoid payer/provider disputes and customer/provider disputes regarding health insurance benefits, payments, and physician participation. Requires meeting and providing orientation and education of managed care payer contracts to new physicians and practice administrators.

Requirements Educational Requirements Degree/Diploma Obtained Program of Study Required/
Preferred and/or Bachelor'sScienceRequiredor Bachelor'sArtsRequired Experience Requirements Minimum Years Required Area of Experience Required/
Preferred and/or 5 YearsMarketing/Sales/Provider RelationsRequired Additional RequirementsExperience in managed care contracting, provider relations, marketing, physician office practice management or similar position. State of Florida Licensure Requirements Licenses Required/
Preferred and/or Not Required Certifications/Registration Requirements Certificates/Registrations Required/
Preferred and/or

US:FL:Fort Myers