What does a Managed Care Director do?

A managed care director works in the medical field, typically in a hospital or a care center, such as an elderly care or rehabilitation facility. He or she usually answers to the department head, or if the director is the department head, he or she might answer to the facility director. The job is usually a diverse one that may include maintaining the managed care departmental operations, putting together and coordinating projects between departments, and developing and maintaining contracts with purchasers and providers. In larger companies, the director may have one or more assistants that perform some of these duties; in smaller companies, the director may be assigned more jobs without the aid of an assistant.

Generally, a managed care director needs to have effective leadership and management skills. The director frequently coordinates tasks and communications between the managed care department's operational staff, clinical staff, and, sometimes, the administration. Many times, it is the director's job to develop and retain lucrative business associations with insurers and care providers. These duties often require strong communication skills.

Negotiating agreements with other businesses is normally a managed care director's job. This frequently includes contracts with corporations such as other hospitals and health care systems; health insurance companies; state, federal, territorial, or other governmental agencies; and additional providers and purchasers. During the contract negotiations, the director typically is expected to negotiate cost-effective terms for new contracts. Knowledge of hospital finances, including patient accounting principles, often increases a person's likelihood of being hired as a managed care director. Generally, part of these duties includes compiling and maintaining an accurate database of provider and purchaser contracts, so knowledge of database management is often required.

At some facilities, the job may include identifying opportunities to increase the facility's market share, usually by promoting the existing services or developing new ones. The director may play a leading role in addressing scenarios to improve the facility's performance and increase the financial assets; therefore, he or she might also answer to the facility's financial director.

The job description of a managed care director varies greatly depending upon the needs of the facility. During the course of his or her duties, the managed care director might be responsible for coordinating projects with the managed care staff, the hospital administration, patient services, or other facility departments. He or she may also be asked to negotiate staff contracts if the facility is small and lacks a human resource department.