Managed Care Client Services Director- Location Open - (US-TN-Memphis - 38197)

Minimum Education: Tech School
Job Type: Full Time
Jobcode: 1724082
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Managed Care Client Services Director

CLAIM YOUR FUTURE AS A GREAT PERFORMER!
Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities. We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. We are proud to have been voted the Best TPA in America for 2005 and 2006, and the first and only Third Party Administrator to receive the coveted Employer of Choice designation. Come be a part of our team and "Claim Your Future."

PRIMARY PURPOSE:
To provide managed care expertise to current and potential Company clients; to support business development, program management and operational teams in providing quality cost containment programs to clients; to implement custom client solutions designed to improve managed care product performance and operational workflows and increase revenue and client outcomes/satisfaction.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Provides managed care expertise in new/renewal sales presentations, program rounding, managed care program design, and client implementations.
Participates in new client implementations, consulting with Managed Care Practice Leader and Managed Care Implementation Manager throughout the project plan and roll-out of program.
Participates in client stewardship meetings developing required reporting to support managed care product savings outcomes and delivery of services, and presentation of new managed care products.
Identifies required resources for managed care program support; assigns responsibilities to team participants; and provides oversight to ensure success.
Facilitates regulatory requirements, included but not limited to provider panel posting development, CA MPN solution, and MCO filing documentation.
Supports Program Management initiatives to meet client expectations, program customization, outcomes reporting, benchmarking/analytics, trending and scorecarding to increase revenue and meet client objectives.
Negotiates changes to Managed Care client budgets, contract/addendums, model design, custom reporting, performance guarantees and client service instructions.
Supports client relationships, builds executive relationships; supports internal relationships, client/company knowledge; and resolves major customer services issues as needed.
Supports Managed Care Practice Leader in development of subject matter expertise and team bench strength for growth in the Managed Care team.
Develops and presents Managed Care product training components.
Supports the total performance management initiative.
Travels as required


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