What does a Managed Care Director do?

A managed care director works in the medical field, usually in a hospital or a care facility for the elderly or rehabilitation. He or she typically reports to the department head, or the facility director if the director is also the department head. Maintaining the managed care department’s operations, putting together and coordinating projects between departments, and developing and maintaining contracts with purchasers and providers are all common responsibilities. In larger companies, the director may have one or more assistants to help with some of these responsibilities; in smaller companies, the director may be given more responsibilities without the assistance of an assistant.

In general, a managed care director must possess strong leadership and management abilities. The director frequently coordinates tasks and communications between the operational staff, clinical staff, and, on occasion, the administration of the managed care department. It is frequently the director’s responsibility to cultivate and maintain profitable business relationships with insurers and care providers. These responsibilities frequently necessitate excellent communication abilities.

A managed care director’s job typically entails negotiating agreements with other businesses. Contracts with corporations such as other hospitals and health care systems; health insurance companies; state, federal, territorial, or other governmental agencies; and other providers and purchasers are frequently included. The director is typically expected to negotiate cost-effective terms for new contracts during contract negotiations. The ability to understand hospital finances, including patient accounting principles, improves one’s chances of being hired as a managed care director. Compiling and maintaining an accurate database of provider and purchaser contracts is usually part of these responsibilities, so database management skills are often required.

Identifying opportunities to increase the facility’s market share, usually promoting existing services or developing new ones, may be part of the job description at some facilities. The director may take the lead in addressing scenarios to improve the facility’s performance and increase financial assets; as a result, he or she may report to the financial director of the facility.

A managed care director’s job description varies greatly depending on the needs of the facility. The managed care director may be in charge of coordinating projects with the managed care staff, hospital administration, patient services, or other facility departments as part of his or her responsibilities. If the facility is small and lacks a human resource department, he or she may be asked to negotiate employee contracts.