Job: Administrator of Managed Care (Open & Promotional)

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Pay: $114,254.40 to $142,833.60/year

Salary : $54.93 - $68.67 Hourly $4,394.40 - $5,493.60 Biweekly $9,521.20 - $11,902.80 Monthly $114,254.40 - $142,833.60 Annually

Posted: 04/18/2018

Job Status: Full Time

Job Reference #: 2024427

Job Description

Overall Job Objective

Job Title:Administrator of Managed Care (Open & Promotional)
Salary:$54.93 - $68.67 Hourly
$4,394.40 - $5,493.60 Biweekly
$9,521.20 - $11,902.80 Monthly
$114,254.40 - $142,833.60 Annually
Job Type:Full-Time
Location:San Mateo County, California
 

Note: This recruitment schedule was amended on April 4, 2018 to extend the Final Filing Date.  This recruitment has been changed to "Continuous."

San Mateo Medical Center
is seeking a motivated professional to fill the position of Administrator of Managed Care.

Through growth and change, San Mateo Medical Center (SMMC) remains committed to providing quality medical care to meet the health needs of the community. Our commitment is to provide quality patient centered care with a compassionate touch.

San Mateo Medical Center is an integrated delivery system of healthcare focused on the needs of the underserved, within a County system of care.  SMMC serves as a key provider within the Health Plan of San Mateo's (HPSM) public/private network.  Our integrated delivery system includes a fully accredited acute care hospital, specialty services, ancillary services, emergency services, and psychiatric services.

SMMC is licensed to operate 509 beds including a 64-bed medical/surgical unit, a 7-bed intensive care unit, a 34-bed inpatient psychiatric services unit and 32 skilled nursing beds in San Mateo. We also oversee the operation of Burlingame Long-Term Care.

Under the general direction of the Deputy Director of Ambulatory Services, The Administrator is responsible for planning, managing, and operationalizing Managed Care capitation agreements with a focus on Population Health Management, between the Health Plan of San Mateo and San Mateo Medical Center.

The ideal candidate will possess at least five years of experience with progressive responsibility in the healthcare environment, at least three of which should be in managed care or ambulatory operations. Additionally, a thorough understanding of the healthcare market, managed care, physician organizations and knowledge of relevant state and federal regulations is mandatory. Certification in Lean Six Sigma is highly preferred.


 Examples Of Duties:
Duties may include, but are not limited to, the following:
  • Serving as program manager of the capitation contract implementation, lead ongoing operational aspects of the job in terms of interfacing with the Ambulatory Network including Medical Directors, Clinic Managers, Supervisors, providers and staff.
  • Providing supervision to Managed Care Analysts in designated regions. Manage the design, implementation and maintenance of the managed care information system that tracks all contract activity across the Ambulatory Network, including Managed Care databases, educational manuals, contract rate dissemination and education.
  • Building and maintaining relationships with health plan personnel to enable strong operational results, contract compliance and expanded pay-for-performance opportunities.
  • Directing the outreach process for North, Coastal, Mid and South regions of the county and coordinate the communication between managed care and Ambulatory Network regarding panel management, access, outreach initiatives, care coordination and service utilization.
  • Working with the Chief Financial Officer (CFO) and other Executive team members to resolve managed care operational issues, develop and implement hospital revenue growth strategies
  • In coordination with CFO and Deputy Director of Ambulatory Services, participate in the design and implementation of new capitation reimbursement structures and preparation of financial impact analysis/ modeling on new and revised contracts.
  • Maintains good rapport and cooperative working relationships with internal and external clients to ensure contract compliance, successful transition to capitation model and implementation of outreach initiatives.

 Qualifications:

Knowledge of:
  • Federal, State and local laws and regulations applicable to assigned area of responsibility, such as public liability and/or accounting laws.
  • Advanced principles and practices of fiscal resource planning.
  • Advanced principles of financial administration, including public budgeting and reporting.
  • ­Advanced principles of financial and actuarial forecasting and financial analysis.
  • Basic principles and practices of County-wide operations and its administration and organization.
  • Principles of personnel training, supervision and evaluation.
  • Computer systems and applications as used within the County.
 
Skill/Ability to:
  • Plan, organize, supervise, coordinate, direct, organize and participate in a wide variety of advanced administrative and operational activities related to the assigned work section, program area specialty or department.
  • Coordinate activities with other departments, programs and/or outside agencies.
  • Direct and participate in the analysis of a wide variety of highly complex administrative and operational problems and make effective operational and/or procedural recommendations.
  • Develop, administer and interpret policies, guidelines and procedures related to the assigned program area.
  • Plan, schedule and manage large scale projects.
  • Negotiate agreement between differing individuals and groups of individuals.
  • Monitor current and proposed Federal, State and local legislation which impact on assigned area of responsibility.
  • Utilize appropriate interpersonal style and methods of communication to gain acceptance, cooperation, or agreement of a plan, activity, and/or program idea.
  • Work cooperatively with other County departments and public and private organizations.
  • Supervise, evaluate and train assigned personnel.
  • Communicate effectively both orally and in writing.
  • Perform complex mathematical and statistical calculations accurately.
  • Prepare complex and detailed written reports, procedures, grant applications and contracts.
  • Establish and maintain effective work relationships with those contacted in the performance of required duties.
 
Education and Experience:
Any combination of education and experience that would likely provide the required knowledge, skills and abilities is qualifying. 

A typical way to qualify is: Three years of increasingly responsible experience performing a wide variety of administrative, financial, managerial or automation duties in a large, complex public agency.

 Application/Examination:
Open and Promotional. Anyone may apply. Current San Mateo County and San Mateo County Superior Court employees with at least six months (1040 hours) of continuous service in a classified regular, probationary, SEIU or AFSCME represented extra-help/term position prior to the final filing date will receive five points added to their final passing score on this examination.
 
The examination process will consist of an application screening (weight: pass/fail) based on the candidates' application and responses to the supplemental questions. Candidates who pass the application screening will be invited to a panel interview (weight: 100%). Depending on the number of applicants, an application appraisal of education and experience may be used in place of other examinations or further evaluation of work experience may be conducted to group applicants by level of qualification. All applicants who meet the minimum qualifications are not guaranteed advancement through any subsequent phase of the examination. All examinations will be given in San Mateo County, California and applicants must participate at their own expense. 

This is a continuous recruitment which may close at any time. The final filing date will be posted five days in advance on this job announcement.

IMPORTANT: Applications for this position will only be accepted online. If you are currently on the County's website, you may click the 'Apply' button above or below. If you are not on the County's website, please go to http://jobs.smcgov.org to apply. Online applications must be received by the Human Resources Department before the final filing date.

Apply immediately. This recruitment is open on a continuous basis and selections may be made at any time within the process.

~ TENTATIVE RECRUITMENT SCHEDULE ~
Final Filing Date: Continuous 
First Round Screening: April 11, 2018
First Round Combined Panel/Department Interviews: May 3, 2018

At the County of San Mateo, we take pride in the way our employees bring together their diverse backgrounds, experiences, and perspectives to serve our community's needs.

The County is an Equal Employment Opportunity Employer.

Analyst - Wendy Young (032118) - (Financial Services Manager II - D151)

 

Application Instructions

To learn more about the position and/or to apply, please click the link below. If link is not available, please read the information above for detailed instructions on how to apply.

Apply Online
 
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