Managed Care Operations Specialist

3 weeks ago

Camden New Jersey, United States Cooper University Hospital Full time
About Us:

At Cooper University Health Care, our commitment to delivering exceptional healthcare services begins with our team of dedicated professionals.

We strive to provide a work environment that fosters innovation, collaboration, and growth opportunities for our employees.

Our commitment to our employees includes competitive compensation, comprehensive benefits, and professional development opportunities.

Discover why Cooper University Health Care is a leading healthcare employer in South Jersey.

Job Summary:

We are seeking a skilled Managed Care Operations Specialist to join our team. The successful candidate will be responsible for maintaining and updating Epic and contract management tools, serving as a Subject Matter Expert for both systems, and troubleshooting issues related to contract logic and claim processing.

The ideal candidate will have knowledge of payor contracting methods and reimbursement processes, as well as experience with Excel, Word, Access, and Epic.

Responsibilities:

  • Maintain and update Epic and contract management tools to ensure accuracy and efficiency.
  • Serve as a Subject Matter Expert for both systems, providing guidance and support to team members.
  • Troubleshoot issues related to contract logic and claim processing, submitting help tickets as needed.
  • Develop and maintain contract variance reports to identify inconsistencies.
  • Update billing teams with contract documents and serve as a liaison between Billing and Managed Care.
  • Develop and maintain reporting and modeling capabilities in both Epic and contract management tools.
  • Participate in system meetings to stay up-to-date on new upgrades and features.
  • Run ad hoc reports and complete impact analysis as requested.
  • Provide backup support to Business Data Analyst as assigned.
Requirements:

To be successful in this role, you will need:

  • Proficiency in Excel, Word, Access, and Epic.
  • Experience in a hospital or physician business office environment, particularly in a billing or health plan administration capacity.
  • Strong written and verbal communication skills.
  • Ability to work independently and as part of a team.
  • Deadline-oriented and able to manage multiple complex projects.
Education and Certification:

A Bachelor's Degree in Data Analytics, Finance, or Healthcare/Business Administration is preferred.

Epic Certification in Resolute Hospital Billing or Resolute Physician Billing is required.

  • Managed Care Operations Specialist

    3 weeks ago

    Camden, New Jersey, United States Cooper University Hospital Full time

    About Us:At Cooper University Health Care, our commitment to delivering exceptional healthcare services begins with our team of dedicated professionals.We strive to provide a work environment that fosters innovation, collaboration, and growth opportunities for our employees.Our commitment to our employees includes competitive compensation, comprehensive...

  • Centralized Intake Managed Care Specialist

    1 hour ago

    New Bedford, Massachusetts, United States SLP Operations, LLC Full time

    Job Title: Centralized Intake Managed Care SpecialistAt SLP Operations, LLC, we are committed to providing exceptional care and services to our residents. We are seeking a highly skilled and detail-oriented Centralized Intake Managed Care Specialist to join our team.Job Summary:This role is responsible for reviewing and verifying insurance benefits,...

  • Revenue Cycle Operations Specialist

    3 weeks ago

    Camden, New Jersey, United States Cooper University Hospital Full time

    About Us:At Cooper University Health Care, our commitment to providing exceptional healthcare services begins with our team. Our dedicated professionals are continuously discovering innovative clinical solutions and enhancing access to the latest facilities, equipment, technologies, and research protocols.We have a strong commitment to our employees by...

  • Program Planning Specialist

    2 weeks ago

    Camden, New Jersey, United States Trispoke managed services Full time

    Job DescriptionJob SummaryWe are seeking a highly skilled Program Planning Specialist to join our team at Trispoke Managed Services. As a Program Planning Specialist, you will be responsible for managing the development and maintenance of complex program schedules, including resource loading and Earned Value Analysis.Key ResponsibilitiesDevelop and maintain...

  • Operating Room Nurse

    1 week ago

    Camden, New Jersey, United States Talent4Health Full time

    Job Title: Operating Room Nurse - Trauma Care SpecialistTalent4Health is seeking a skilled Operating Room Nurse to join our team in Camden, New Jersey. As a Trauma Care Specialist, you will be responsible for providing high-quality patient care in a fast-paced OR environment.About the Role:Specialty: Operating RoomDiscipline: Registered NurseDuration: 13...

  • Financial Operations Specialist

    2 weeks ago

    Camden, New Jersey, United States The Michaels Organization Full time

    Job SummaryWe are seeking a highly skilled Financial Operations Specialist to join our team at The Michaels Organization. As a key member of our financial operations team, you will be responsible for ensuring the accuracy and timeliness of financial transactions related to our housing programs.Key ResponsibilitiesReview and correct tenant ledgers to ensure...

  • Care Coordinator Specialist

    6 days ago

    Camden, New Jersey, United States Cooper University Hospital Full time

    About UsAt Cooper University Health Care, we prioritize delivering exceptional healthcare services. Our dedicated professionals continually discover innovative clinical approaches and enhance access to cutting-edge facilities, equipment, technologies, and research protocols. We offer competitive compensation, comprehensive benefits, attractive working...

  • Clinical Risk Management Specialist

    4 weeks ago

    Camden, New Jersey, United States Cooper University Health Care Full time

    About Our OrganizationAt Cooper University Health Care, we prioritize exceptional health care through our dedicated team. Our professionals are at the forefront of clinical advancements, ensuring access to the latest facilities, equipment, technologies, and research methodologies. We are committed to our employees by offering competitive compensation,...

  • Manager of Repair Operations

    4 weeks ago

    Camden, New Jersey, United States STERIS - Commercial Operations Full time

    Position OverviewAt STERIS, we are dedicated to assisting our clients in fostering a healthier and safer environment through our innovative healthcare and life science solutions.Role SummaryThe Supervisor of Repair Operations is responsible for overseeing the repair functions within their designated department or category.This role entails ensuring the...

  • Supply Chain Risk Management Specialist

    2 weeks ago

    Camden, New Jersey, United States Cooper University Hospital Full time

    About UsAt Cooper University Health Care, our commitment to delivering exceptional healthcare services begins with our team of dedicated professionals. Our team is continuously discovering innovative clinical solutions and enhancing access to the latest facilities, equipment, technologies, and research protocols. We prioritize our employees by offering...

  • Critical Care Specialist

    2 weeks ago

    Camden, New Jersey, United States Cooper University Hospital Full time

    About Us:At Cooper University Health Care, our commitment to providing exceptional healthcare begins with our team. Our dedicated professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies, and research protocols. We offer competitive rates and compensation, a comprehensive...

  • Nurse Care Specialist

    3 weeks ago

    Camden, Tennessee, United States Tennessee Quality Care Full time

    Job Summary:Tennessee Quality Care is seeking a skilled Registered Nurse to join our Home Health Division. As a Nurse Care Specialist, you will provide personalized medical care to patients recovering from surgery or illness, coping with a difficult health challenge, or seeking end-of-life care.Responsibilities:Provide visits as assigned by the Clinical...

  • Clinical Care Specialist

    4 weeks ago

    Camden, New Jersey, United States Cooper University Health Care Full time

    About Us At Cooper University Health Care, we are dedicated to delivering exceptional health services, which starts with our talented team. Our remarkable professionals are consistently exploring clinical advancements and improving access to the latest facilities, equipment, technologies, and research methodologies. We prioritize our employees by offering...

  • Division Operations Coordinator

    2 weeks ago

    Camden, New Jersey, United States Cooper University Hospital Full time

    About Us:At Cooper University Health Care, our commitment to providing exceptional healthcare begins with our team. Our dedicated professionals are continuously discovering innovative clinical practices and enhancing access to the latest facilities, equipment, technologies, and research protocols. We prioritize our employees by offering competitive...

  • Pediatric Care Specialist

    3 weeks ago

    Camden, New Jersey, United States Cooper University Hospital Full time

    About Our Pediatric Care TeamAt Cooper University Hospital, we are committed to providing exceptional care to our pediatric patients and their families. Our team of dedicated professionals is passionate about delivering high-quality, patient-centered care in a safe and supportive environment.Job SummaryWe are seeking a skilled and compassionate Pediatric...

  • Quality Management Specialist

    3 weeks ago

    Camden, United States Upward Health Full time

    Job DescriptionJob DescriptionQUALITY MANAGEMENT SPECIALIST Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help. Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and...

  • Division Operations Coordinator

    3 weeks ago

    Camden, New Jersey, United States Cooper University Hospital Full time

    About Cooper University Health Care:We are a leading healthcare provider in South Jersey, committed to delivering exceptional patient care and innovative medical services. Our team of dedicated professionals is passionate about making a difference in the lives of our patients and their families.Job Summary:We are seeking a highly organized and...

  • Pediatric Care Specialist

    1 week ago

    Camden, New Jersey, United States Cooper University Hospital Full time

    About UsAt Cooper University Health Care, we're dedicated to delivering exceptional healthcare services. Our team of professionals is committed to staying at the forefront of clinical innovation, ensuring our patients receive the best possible care. We offer competitive compensation, comprehensive benefits, and opportunities for professional growth and...

  • Pediatric Care Specialist

    1 week ago

    Camden, New Jersey, United States Cooper University Health Care Full time

    About UsAt Cooper University Health Care, our commitment to delivering exceptional healthcare begins with our team. Our dedicated professionals are continually discovering innovative clinical practices and providing access to the latest facilities, equipment, technologies, and research protocols. We offer competitive compensation, a comprehensive benefits...

  • Wound Care Specialist

    1 week ago

    Cranford, New Jersey, United States Integrated Wound Care Full time

    Wound Care Specialist OpportunityIntegrated Wound Care is seeking a skilled Part Time Medical Doctor to provide high-quality wound care services to our patients. As a leading provider of wound care services, we aim to deliver exceptional care to skilled nursing, long-term care, and rehabilitation facilities.Key Responsibilities:Conduct thorough patient...