A managed care director oversees operations, coordinates projects, and negotiates contracts with insurers and care providers in the medical field. They need strong leadership and communication skills and knowledge of hospital finances. The job description varies depending on the facility’s needs.
A managed care director works in the medical field, usually in a hospital or care center, such as an elderly care or rehabilitation center. He or she usually reports to the department head or, if the director is the department head, he or she may report to the facility director. The work is often diverse and may include maintaining managed care department operations, setting up and coordinating projects across departments, and developing and maintaining contracts with buyers and suppliers. In larger companies, the director may have one or more assistants who perform some of these functions; in smaller companies, the director may be given more jobs without the help of an assistant.
Generally, a director of managed care needs to have effective leadership and management skills. The director often coordinates tasks and communications between the managed care department’s operating staff, clinical staff, and sometimes administration. It is often the director’s job to develop and maintain profitable business associations with insurers and care providers. These tasks often require strong communication skills.
Negotiating agreements with other companies is typically the job of a managed care director. This often includes contracts with companies such as other hospitals and health systems; health insurance companies; state, federal, territorial or other governmental agencies; and additional suppliers and buyers. During contract negotiations, the director is expected to negotiate economic terms for new contracts. Knowledge of hospital finances, including patient accounting principles, generally increases the likelihood that a person will be hired as a director of managed care. Often part of these duties include compiling and maintaining an accurate database of supplier and buyer contracts, so knowledge of database management is often required.
At some facilities, work may include identifying opportunities to increase the facility’s market share, typically by promoting existing services or developing new ones. The director can play a leadership role in addressing scenarios to improve facility performance and increase financial assets; therefore, he or she may also report to the facility’s CFO.
The job description of a managed care director varies greatly depending on the needs of the facility. While performing their duties, the director of managed care may be responsible for coordinating projects with the managed care team, hospital administration, patient services, or other departments at the facility. He or she may also be asked to negotiate staffing contracts if the facility is small and does not have a human resources department.
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