Managed Care Financial Manager pay range

What the state says the job is

This is professional and administrative work directing policy development, financial management, contract management, and rate setting for statewide capitated managed care programs in the Department of Human Services (DHS). An employee in this job directs and monitors rate setting, fiscal policy development and implementation, institutional provider cost reporting, and financial management for departmental managed care and fee-for-service programs. Work involves directing the development of policies and procedures relating to rate development, budgetary projections, third party collections, stop-loss provisions, reinsurance and other forms of risk limitation, and financial monitoring plans for managed care organizations or fee-for-service providers.

Examples of the work

• Directs the management and monitoring of actuarial support services. • Directs the development and implementation of Requests for Proposals (RFPs), and evaluation criteria for the statewide expansion of mandatory capitated managed care. • Directs the contracting process for health care consulting services. • Directs and participates in the administration, control, and monitoring of managed care reserve accounts. • Negotiates rates and supplemental payments with providers for DHS review and approval. • Issues, negotiates, and processes Medicaid managed care or behavioral health agreements between DHS and behavioral health managed care primary contractors.

Minimum qualifications

• Six years of professional accounting and financial management experience, including three years in a supervisory capacity, and a bachelor’s degree in accounting, finance, or a closely related field, which includes or is supplemented by twelve college credits in accounting; or • An equivalent combination of experience and training which includes three years of professional supervisory experience in accounting and financial management and twelve college credits in accounting.