Managed Care Contracting Specialist
3 weeks ago
At CommuniCare Family of Companies, we are seeking a skilled Managed Care Contracting Specialist to join our team. This role is responsible for overseeing strategy and development for all Managed Care Services, Case Management, and Contracting.
The ideal candidate will have a general understanding of regional, state, and federal regulations, laws, and legislative agendas regarding the healthcare industry that impact CommuniCare. They will also be able to develop and foster strong payor relationships built on trust and collaboration, as well as meet and manage payor requirements throughout the business development and contracting process.
Key responsibilities of this role include:
- Developing and implementing managed care strategies to improve partnership models
- Collaborating with team members to negotiate contracts and resolve payment issues
- Maintaining managed care rate sheets and tracking tools
- Monitoring health plan newsletters and policy updates
- Providing comprehensive training to team members on managed care contracts and processes
Requirements for this role include:
- Long Term Care/SNF experience preferred
- Knowledge and relevant work experience in the Managed Care/insurance sectors in long term care and contract language
- Knowledge of medical contracting methodologies, claims pricing, and reimbursement
- Proficient computer skills and knowledge of Microsoft Office, specifically Excel & pivot tables
- Ability to prioritize and manage multiple projects
We offer a fully remote position with a competitive salary and benefits package. If you are a motivated and detail-oriented individual with a passion for healthcare contracting, we encourage you to apply for this exciting opportunity.
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