DIRECTOR OF MANAGED CARE CONTRACTING & PROVIDER CREDENTIALING SMS-3835

<p data-pasted="true">Under the direct supervision of the Executive Director of Clinical Finance with a dotted line to the Executive Director of Revenue Cycle for Provider Credentialing; the Director of Managed Care Contracting &amp; Provider Credentialing is responsible for providing strategic leadership, financial and administrative oversight of Managed Care contracting with commercial and governmental payers on behalf of SIU Medicine (SIU P&amp;S and SIU FQHC), working closely with departmental staff and physician leadership to develop a portfolio of participating network contracts to enhance revenue and patient access. The Director will also be responsible for oversight and the providing of strategic leadership to the Credentialing Department and will assist with developing credentialing policies and procedures when needed. Responsible for providing on-going analysis of SIU Medicine's risk-based insurance products held in joint venture with partner organizations. Works closely with the Executive Director of Clinical Finance and Managed Care Analyst on reimbursement modeling and the revenue cycle team for payer variance analysis and payer issues.</p> <undefined><strong>Minimum Qualifications:</strong></undefined><br><undefined>1. Bachelor's Degree in Healthcare Administration, Business Administration or related field required.<br data-pasted="true">2. Extensive knowledge and experience with health insurance claim data and/or Managed Care payment <br>methodologies.<br>3. Knowledge of Federal and State regulatory environment related to Managed Care. Minimum 7-10 years <br>of experience working with and negotiating Managed Care contracts with payers and/or negotiating <br>contracts on behalf of a managed care organization.<br>4. Sensitive to the needs of underrepresented minority populations.</undefined><br><br><undefined><strong>Desired Qualifications:</strong></undefined><br><undefined>1. Master's Degree highly desired.<br data-pasted="true">2. Previous management experience desired.<br><br></undefined> <undefined><img src="https://secure.neoed.com/images/AgencyImages/jobposting/14507/jobpostings/image/20260828113828_Screenshot 2026-08-28 133739.png" style="width: 300px;" class="fr-fic fr-dii"></undefined>