Assistant Director, Managed Care Operations

General Information

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Work Location: Los Angeles, USA Onsite or Remote Flexible Hybrid Work Schedule Monday - Friday, 8:00-5:00pm PST Posted Date 10/21/2024 Salary Range: $112900 - 256900 Annually Employment Type 2 - Staff: Career Duration Indefinite Job # 20111

Primary Duties and Responsibilities

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The Assistant Director, Managed Care Operations is responsible for the collaborative development, implementation and ongoing operations of financial and administrative policies, procedures and systems to achieve the goals set by leadership for UCLA Medical Group managed care contract performance.  

In this role, you will assist the Director, Managed Care Operations in ensuring the integration of key managed care activities to promote effective teamwork to efficiently support the achievement of cost-effective, high quality operational processes.

Primary responsibilities include, but are not limited to, the following:

• facilitate and provide detailed analysis, reporting, training, education and support to leadership and the management team to promote financial success
• develop and maintain effective communication with key departments regarding managed care initiatives and operations, with affiliated contracted entities and with health plans
• ensure the Claims and System support business units are compliant with required contractual and regulatory obligations

Salary offers are determined based on various factors including, but not limited to, qualifications, experience, and equity. The full salary range for this position is $112,900 -  $256,900 annually. The budgeted salary or hourly range that the University reasonably expects to pay for this position is approximately between the minimum and midpoint. 

Job Qualifications

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We are seeking a dynamic leader with: 

• A Bachelor’s degree

• Minimum of 10 years experience in an HMO environment (i.e. MSO or IPA setting) in administration and maintenance of Provider, Fee Schedule and Benefit information in a managed care claims payment application

• Minimum of 5 years managerial experience

• Thorough knowledge of the delegated health care model, capitation and other managed care IPA and provider reimbursement methodologies

• Skill in contract interpretation and benefit interpretation

• In-depth knowledge of CPT-4, ICD-10, and HCPCS codes

• Proficient computer skills including Internet search capabilities, Microsoft Word, Excel and Access

• Extensive understanding of Managed Care systems (i.e. EZ Ca