Managed Care Provider Relations Manager jobs in Hawaii

We are, and always will be, dedicated to improving the health of Native Hawaiians and all of the people of Hawai‘i.

The Queen’s Health System began with a single hospital in 1859 founded by Queen Emma and King Kamehameha IV to provide health care and healing. We now have four hospitals and more than 70 preventive, specialty health care locations and labs throughout the Pacific region.

Our caregiver team includes more than 8,000 employees and over 1,400 physicians networked throughout Hawai‘i and the Pacific Basin.

We’re collaborators who care. We listen to and learn from each other to ensure that our patients benefit and our communities blossom.

If this sounds like an ideal place for your career to grow, we hope you’ll join our ‘ohana!

I. JOB SUMMARY/RESPONSIBILITIES:

• Assists in development, maintenance and administration of the medical centers’ contracts with health insurers for services provided to members.
• Performs financial analysis, operational evaluation, and compliance issues on payer agreements to recommend action for executive review.
• Makes recommendations for optimal member utilization and objective financial criteria.
• Functions as a member of the contracting team to negotiate optimal contractual agreements.
• Responsible for maintenance of contract modules.
• Serves as a liaison with selected payers to promote the service of the medical center and improve provider relations with third party payers.

II. TYPICAL PHYSICAL DEMANDS:

• Essential/continuous: Sitting, finger dexterity seeing, hearing, speaking, repetitive arm/hand motions, static gripping of an object for prolonged periods, frequent gripping of an object.
• Operates computer, typewriter, calculator, telephone, fax and printer.

III. TYPICAL WORKING CONDITIONS:

• Not substantially subjected to adverse environmental conditions.

IV. MINIMUM QUALIFICATIONS:
A. EDUCATION/CERTIFICATION AND LICENSURE:

• Bachelor’s degree in Business, Finance or Health Care Administration or four (4) years with health care provider or payer in contracting or business operations.
• Master’s degree in related field preferred.
• Knowledge of healthcare delivery systems, including contracting and financial analysis.
• Knowledge of current regulatory billing and collection policies and procedures.
• Knowledge of computer assisted analytical tools including word processing, spreadsheet, and software for hospital contract and/or claims management.

B. EXPERIENCE:

• In additional to the educational requirement, two (2) years experience with a health care provider or payer in contracting or business operations.
• Demonstrated ability to work independently and effectively with internal and external personnel at various levels of responsibility.

Equal Opportunity Employer / Disability / Vet

Job Type: Full-time

Pay: $61,649.00 - $75,520.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Ability to Relocate:

• Honolulu, HI 96813: Relocate before starting work (Required)

Work Location: In person