Managed Care Specialist

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🔥 5 minutes ago

🏈 Alabama, Alaska, +31 more states – Remote

🏈 Alabama – Remote 🐻 Alaska – Remote 🌵 Arizona – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🦬 Montana – Remote 🌾 Nebraska – Remote 🎰 Nevada – Remote 🗻 New Hampshire – Remote 🌶️ New Mexico – Remote 🌲 North Carolina – Remote 🌾 North Dakota – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🚗 Michigan – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote 🧀 Wisconsin – Remote 🦬 Wyoming – Remote

💵 $28 - $42 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 0%

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Advocate Aurora Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

💰 $10.2M Grant on 2019-08

Healthcare • Healthcare Insurance

Advocate Aurora Health is a leading healthcare organization that operates across various regions including Central Chicagoland, Central Wisconsin, Greater Milwaukee, and more. With a diverse range of career areas such as advanced practice clinicians, behavioral health, nursing, and more, Advocate Aurora Health is committed to helping people live well. The organization offers numerous benefits and opportunities for career advancement, fostering an environment where individuals can thrive and innovate in the healthcare sector. Advocate Aurora Health prioritizes the safety of its candidates and maintains a robust recruitment process to protect sensitive information.

📋 Description

• Manages administration of the assigned portion of the contract portfolio • Maintains detailed working knowledge of assigned payor contracts and manages managed care contract administration and compliance activities • Creates and maintains electronic document databases and original permanent files for contract documents • Communicates and educates operational implementation of new contract terms affecting revenue cycle functions • Manages implementation of new or renegotiated managed care agreements • Manages secure distribution of confidential contract documents and communicates contract changes to executives and revenue cycle personnel • Monitors, reports, resolves, and prevents operational issues related to existing managed care contracts • Interacts with revenue cycle staff and MCO provider relations to resolve operational issues • Serves as advisor and point of contact for revenue cycle personnel on managed care operational and administrative issues • Supports designated teammates and Managed Health Resources Provider Services in operational roles • Initiates and facilitates Joint Operating Committee meetings with MCOs and internal issue-resolution meetings • Coordinates meetings, prepares agendas, creates performance reports, and distributes meeting minutes • Reviews payor websites and external information to stay current on payor policies and initiatives • Prepares clear, concise internal communications and correspondence • Determines data sources, performs analyses, and applies methodologies under supervision

🎯 Requirements

• Fulltime, Dayshift Monday - Friday • Fully Remote Role from these states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY • No relocation and no sponsorship or transfer of visa for this position now or in the future • Associate's degree or equivalent experience required • Minimum two years experience in managed care contracting, operations, or patient financial services for large healthcare provider or managed care organization • Experience preparing, processing, and tracking formal business correspondence and contract notifications, including time-sensitive mailed and electronic communications • Strong research and analytical skills, with the ability to identify discrepancies and follow issues through resolution • Experience managing multiple projects, deadlines, work queues, or high-volume administrative assignments • Licensure, Registration, and/or Certification: None Required • Ability to perform work under normal office conditions, including sitting for long periods, standing, walking, repetitive wrist/arm motion, or lifting articles up to twenty-five pounds

🏖️ Benefits

• Benefits Eligible • Competitive compensation • Premium pay such as shift, on call, and more based on a teammate's job • Incentive pay for select positions • Opportunity for annual increases based on performance • Paid Time Off programs • Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability • Flexible Spending Accounts for eligible health care and dependent care expenses • Family benefits such as adoption assistance and paid parental leave • Defined contribution retirement plans with employer match and other financial wellness programs • Educational Assistance Program • Fully remote role • Monday–Friday dayshift schedule

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