Manager, Managed Care & Payer Strategy

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    "jobTitle": "Manager, Managed Care & Payer Strategy",
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    "description": "<p style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><strong><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">About Us</span></strong></span></p>\n\n<p style=\"text-align:justify\"><span style=\"font-family:Aptos,sans-serif\"><strong><span style=\"font-family:Calibri,sans-serif\">Inform Diagnostics, a Fulgent Genetics Company</span></strong><span style=\"font-family:Calibri,sans-serif\">, is a nationally recognized diagnostics laboratory focused on anatomic pathology subspecialties including gastrointestinal pathology, dermatopathology, urologic pathology, hematopathology, and breast pathology. </span></span></p>\n\n<p style=\"text-align:justify\"><span style=\"font-family:Aptos,sans-serif\"><span style=\"font-family:Calibri,sans-serif\">Founded in 2011, our parent entity, Fulgent Genetics, has evolved into a </span><span style=\"font-family:Calibri,sans-serif\">premier, full-service genomic testing company built around a foundational technology platform.</span></span></p>\n\n<p style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Through our diverse testing menu, Fulgent is focused on transforming patient care in oncology, anatomic pathology, infectious and rare diseases, and reproductive health. We believe that by providing a wide range of effective, flexible testing options in conjunction with best-in-class service and support, we can redefine the way medicine is managed for patients and clinicians alike.</span></span></p>\n\n<p style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Since integrating with our therapeutic development business, Fulgent is also developing drug candidates for treating a broad range of cancers using a novel nanoencapsulation and targeted therapy platform. By merging our fields of expertise, we aim to become a fully integrated precision medicine company.</span></span></p>\n\n<p style=\"text-align:justify\">&nbsp;</p>\n\n<p style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><strong><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Summary of Position</span></strong></span></p>\n\n<p style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">The </span><strong><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Manager, Managed Care &amp; Payer Strategy</span></strong><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\"> will assist the Senior Director of Managed Care &amp; Strategic Partnerships in creating and driving strategic contracting and payor partnership initiatives. This position will contribute to successful managed care relationships with focus on achieving increased utilization, supporting quality initiatives, ensuring compliance to contractual agreements, and establishing meaningful payor partnerships with assigned national and regional based payors. The Manager, Managed Care &amp; Payer Strategy will be a strategic business partner, interfacing at the Director and Executive levels of the organization, providing leadership and taking ownership of the defined payor partners.</span></span></p>\n\n<p style=\"text-align:justify\">&nbsp;</p>\n\n<p style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><strong><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Key Job Elements</span></strong></span></p>\n\n<ul>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Coordinates the contract lifecycle, including tracking contract approvals, coordinating wet or electronic signature, and implementation of final payor agreements in conjunction with Sr Director of Managed Care &amp; Strategic Partnerships.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Responsible for maintaining the contract administration database.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Responsible for maintaining the Payor Contract Management System.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Responsible for maintaining the Master Contract Tracking tool.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Work closely and collaborate with internal team members as needed.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Work closely with all assigned national and regional health plans.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Manage the payment variance &amp; health plan performance quarterly review process. To include reimbursement trends, market opportunities, contract performance, and market trends.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Review contract terms and conditions to verify they are in compliance with company policies and all applicable federal and state regulations.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Research regulations to guarantee contracts are updated and in compliance with laws.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Provides training and guidance to Billing, Sales, and Ops on new contracts to ensure department readiness.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Collaborates cross-functionally with RCM, Credentialing, Client Retention Team, Lab Operations, Marketing, and Sales Teams.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Responsible for maintaining and researching health plan coverage policies as those relate to the business.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Under the guidance of the Sr. Director of Managed Care &amp; Strategic Partnerships: manage, negotiate, establish, and administer contractual agreements with a defined book of business inclusive of Fulgent Diagnostics, and it subsidiaries.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Maintains confidentiality and performs duties in a responsible and ethical manner.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Demonstrates curiosity to learn, agility, and flexibility as new projects are assigned.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Support the Managed Care Team with project planning, issuing standard and ad-hoc reports.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Travel as needed to assist the Managed Care department in trainings, presentations, conferences and payer-related meetings or negotiations.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Performs additional duties as may be assigned.</span></span></li>\n</ul>\n",
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The Manager, Managed Care &amp; Payer Strategy will be a strategic business partner, interfacing at the Director and Executive levels of the organization, providing leadership and taking ownership of the defined payor partners.\\n\\n&nbsp;\\n\\nKey Job Elements\\n\\n\\n\\tCoordinates the contract lifecycle, including tracking contract approvals, coordinating wet or electronic signature, and implementation of final payor agreements in conjunction with Sr Director of Managed Care &amp; Strategic Partnerships.\\n\\tResponsible for maintaining the contract administration database.\\n\\tResponsible for maintaining the Payor Contract Management System.\\n\\tResponsible for maintaining the Master Contract Tracking tool.\\n\\tWork closely and collaborate with internal team members as needed.\\n\\tWork closely with all assigned national and regional health plans.\\n\\tManage the payment variance &amp; health plan performance quarterly review process. To include reimbursement trends, market opportunities, contract performance, and market trends.\\n\\tReview contract terms and conditions to verify they are in compliance with company policies and all applicable federal and state regulations.\\n\\tResearch regulations to guarantee contracts are updated and in compliance with laws.\\n\\tProvides training and guidance to Billing, Sales, and Ops on new contracts to ensure department readiness.\\n\\tCollaborates cross-functionally with RCM, Credentialing, Client Retention Team, Lab Operations, Marketing, and Sales Teams.\\n\\tResponsible for maintaining and researching health plan coverage policies as those relate to the business.\\n\\tUnder the guidance of the Sr. Director of Managed Care &amp; Strategic Partnerships: manage, negotiate, establish, and administer contractual agreements with a defined book of business inclusive of Fulgent Diagnostics, and it subsidiaries.\\n\\tMaintains confidentiality and performs duties in a responsible and ethical manner.\\n\\tDemonstrates curiosity to learn, agility, and flexibility as new projects are assigned.\\n\\tSupport the Managed Care Team with project planning, issuing standard and ad-hoc reports.\\n\\tTravel as needed to assist the Managed Care department in trainings, presentations, conferences and payer-related meetings or negotiations.\\n\\tPerforms additional duties as may be assigned.\\n\\nQualificationsKnowledge/Experience\\n\\n\\n\\tBA/BS degree in Healthcare Administration, Business, or related business field.\\n\\tMinimum five (5) years of healthcare experience is required; Laboratory healthcare preferred.\\n\\tMust have three (3) years working with healthcare contract terms, reimbursement methods, or managing a health plan book of business to include contract administration principles; and have basic contract language interpretation skills.\\n\\tSkills in project management including documentation, attention to detail, diligent follow-up, and organization essential.\\n\\tExcellent communication, especially written, and the ability to concisely summarize information.\\n\\tDemonstrated proficiency in Microsoft Word, Excel, Access, Power Point, Power BI, and Outlook are required.\\n\\tExcellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external.\\n\\tExercises sound judgment in responding to inquiries; understands when to escalate inquiries.\\n\\tSelf-motivated and capable of working independently, as well as part of a team.\\n\\tMust be able to manage multiple tasks/projects simultaneously within inflexible time frames. 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The term &ldquo;qualified individual with a disability&rdquo; means an individual with a disability who, with or without reasonable accommodation, can perform the essential functions of the position.\\n\\n&nbsp;\\n\\nThis job description reflects management&rsquo;s assignment of essential functions. 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The term &ldquo;qualified individual with a disability&rdquo; means an individual with a disability who, with or without reasonable accommodation, can perform the essential functions of the position.\\n\\n&nbsp;\\n\\nThis job description reflects management&rsquo;s assignment of essential functions. Nothing in this job description restricts management&rsquo;s right to assign or reassign duties and responsibilities to this job at any time\\n\",\"experienceRequirements\":\"Knowledge/Experience\\n\\n\\n\\tBA/BS degree in Healthcare Administration, Business, or related business field.\\n\\tMinimum five (5) years of healthcare experience is required; Laboratory healthcare preferred.\\n\\tMust have three (3) years working with healthcare contract terms, reimbursement methods, or managing a health plan book of business to include contract administration principles; and have basic contract language interpretation skills.\\n\\tSkills in project management including documentation, attention to detail, diligent follow-up, and organization essential.\\n\\tExcellent communication, especially written, and the ability to concisely summarize information.\\n\\tDemonstrated proficiency in Microsoft Word, Excel, Access, Power Point, Power BI, and Outlook are required.\\n\\tExcellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external.\\n\\tExercises sound judgment in responding to inquiries; understands when to escalate inquiries.\\n\\tSelf-motivated and capable of working independently, as well as part of a team.\\n\\tMust be able to manage multiple tasks/projects simultaneously within inflexible time frames. Ability to adapt to frequent priority changes and still meet required deadlines.\\n\\tCapable of working within established policies, procedures and practices prescribed by the organization.\\n\\n\\nSupervisory Responsibilities\\n\\n\\n\\tYes\\n\\n\\nReports to\\n\\n\\n\\tSenior Director of Managed Care &amp; Strategic Partnership\\n\\n\\n&nbsp;\\n\\nEnvironment\\n\\nFulgent Therapeutics LLC is an Equal Employment Opportunity Employer.\\n\\nThe work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions. The term &ldquo;qualified individual with a disability&rdquo; means an individual with a disability who, with or without reasonable accommodation, can perform the essential functions of the position.\\n\\n&nbsp;\\n\\nThis job description reflects management&rsquo;s assignment of essential functions. Nothing in this job description restricts management&rsquo;s right to assign or reassign duties and responsibilities to this job at any time\\n\",\"industry\":\"Biotech\",\"validThrough\":\"-0001-11-30\",\"educationRequirements\":\"4 Year Degree\"}",
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    "qualifications": "<p style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><strong><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Knowledge/Experience</span></strong></span></p>\n\n<ul>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">BA/BS degree in Healthcare Administration, Business, or related business field.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Minimum five (5) years of healthcare experience is required; Laboratory healthcare preferred.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Must have three (3) years working with healthcare contract terms, reimbursement methods, or managing a health plan book of business to include contract administration principles; and have basic contract language interpretation skills.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Skills in project management including documentation, attention to detail, diligent follow-up, and organization essential.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Excellent communication, especially written, and the ability to concisely summarize information.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Demonstrated proficiency in Microsoft Word, Excel, Access, Power Point, Power BI, and Outlook are required.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Exercises sound judgment in responding to inquiries; understands when to escalate inquiries.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Self-motivated and capable of working independently, as well as part of a team.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Must be able to manage multiple tasks/projects simultaneously within inflexible time frames. Ability to adapt to frequent priority changes and still meet required deadlines.</span></span></li>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Capable of working within established policies, procedures and practices prescribed by the organization.</span></span></li>\n</ul>\n\n<p style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><strong><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Supervisory Responsibilities</span></strong></span></p>\n\n<ul>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Yes</span></span></li>\n</ul>\n\n<p style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><strong><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Reports to</span></strong></span></p>\n\n<ul>\n\t<li style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Senior Director of Managed Care &amp; Strategic Partnership</span></span></li>\n</ul>\n\n<p style=\"text-align:justify\">&nbsp;</p>\n\n<p style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><strong><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Environment</span></strong></span></p>\n\n<p style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">Fulgent Therapeutics LLC is an Equal Employment Opportunity Employer.</span></span></p>\n\n<p style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions. The term &ldquo;qualified individual with a disability&rdquo; means an individual with a disability who, with or without reasonable accommodation, can perform the essential functions of the position.</span></span></p>\n\n<p style=\"text-align:justify\">&nbsp;</p>\n\n<p style=\"text-align:justify\"><span style=\"font-family:Arial,sans-serif\"><em><span dir=\"ltr\" lang=\"en\" style=\"font-family:Calibri,sans-serif\">This job description reflects management&rsquo;s assignment of essential functions. Nothing in this job description restricts management&rsquo;s right to assign or reassign duties and responsibilities to this job at any time</span></em></span></p>\n",
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    "description": "About Us\n\nInform Diagnostics, a Fulgent Genetics Company, is a nationally recognized diagnostics laboratory focused on anatomic pathology subspecialti...",
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