Managed Care Specialist

2 weeks ago

Nashville, United States Rose International Full time

Date Posted: 05/22/2024

Hiring Organization: Rose International

Position Number: 464514

Job Title: Managed Care Specialist

Job Location: Nashville, TN, USA, 37243

Work Model: Hybrid

Employment Type: Temporary

Estimated Duration (In months): 7

Min Hourly Rate ($): 23.00

Max Hourly Rate ($): 25.00

Must Have Skills/Attributes: Administrative Assistant, Communications, Contract Management, Data Entry, Microsoft Access, Microsoft Excel


Job Description


**Only those lawfully authorized to work in the designated country associated with the position will be considered. **


**Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client’s business needs and requirements. **


***Only qualified Managed Care Specialist candidates located in the Nashville, TN area will be considered due to the position requiring an onsite presence***


This Managed Care Specialist position is critical to accomplishing Team outcomes related to ensuring that Select Community programs are operating at maximum performance and ensuring that upcoming federal reporting and waiver renewal/amendment deadlines are met. The Managed Care Specialist is needed to assist the ID Services Team in conducting continuous analysis and evaluation of frequent and recurring reports/deliverables/related contract amendments in efforts to enhance program improvement.


Required Education and Experience:

• Bachelor’s degree from an accredited college or university and experience equivalent to 3 years of professional level experience.


Additional Qualifications:

• Excellent Excel skills and experience with all other Microsoft Office Programs.

• Experience interpreting policy or procedural provisions for a Client, Medicaid, or other related health insurance organization is preferred.

• Excellent written and oral communication skills

• Passion and commitment to supporting people with I/DD, person-centered practices, and integrated employment and community living

• Experience with program management and/or grant management

• Experience in contract management

• Experience working in or with Medicaid or disability related programs

• Strong work ethic and self-motived with ability to work well on a team

• Organizational skills, including the ability to prioritize, multi-task and manage workload to meet specific timeframes and deadlines

• Ability to adapt to changing priorities and deadlines


Required Skills and Abilities:

• Microsoft Access

• Administrative Assistant

• Correspondence – Email

• Correspondence – General

• Customer Service

• Customer Service Skills

• Data Entry

• Emailing

• Internet

• Microsoft Excel

• Microsoft PowerPoint

• Microsoft Word

• Verbal Communication


Managed Care Specialist Responsibilities:

• Conduct continuous analysis and evaluation of frequent and recurring reports/deliverables/related contract amendments in efforts to enhance program improvement.

• Complete 1915(c) post-payment Utilization Reviews

• Update/analyze/validate federally mandated 1915(c) quality data on a monthly basis

• Perform careful review and contribution to the upcoming 2025 1915(c) waiver renewals


Benefits:

For information and details on employment benefits offered with this position, please visit here. Should you have any questions/concerns, please contact our HR Department via our secure website.


California Pay Equity:

For information and details on pay equity laws in California, please visit the State of California Department of Industrial Relations' website here.

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