The Managed Care Specialist I will support the integration activities for the Managed Care Department which will include coordinating all activities with the appropriate business owners, Clinical leaders, Provider Enrollment, Revenue Cycle Management and Managed Care Departments.
Responsibilities
Assist contract managers/ analyst in compiling documents for contract negotiations and final approval (i.e. spreadsheets, payment policies, and fee schedules)
Prepares all requisite supporting documentation (i.e. payment policies, provider manual, entity listings) for managed care contracts
Review and audit contract approval cover sheet and contract for signature from clinical leadership
Responds to and follow-ups with requests for information related to managed care contracts
Responsible for organizing, maintaining, and auditing managed care contracting documents
Conduct research, collect and analyze data to prepare reports and documents
Update and audit contract management system (PALMS)
EFT/ERA process (includes EFT distribution notice, follow-up with departments involved in the EFT/ERA process)
Other duties as assigned
Responsible for adhering to Information Security Policies and ensuring Envision is as secure as possible.
Qualifications
Knowledge and Skills:
Strong knowledge base of Managed Care environment and how agreements flow from negotiation to operationalization and monitoring
Ability to facilitate tasks in a matrixed environment across internal stakeholders and influence deliverables against timelines
Familiarity with Physician, ASC payor contract language
Strong independent problem-solving and critical thinking skills
Ability to work in a fast paced and changing environment
Good organizational and written/oral communication skills
Excellent ability to manage to deadlines
Ability to positively handle conflict
Must be fluent in Microsoft Office applications with strong Excel skills and advanced Microsoft Office, Access, and reporting tools preferred
Other Qualifications:
Must be able to handle multiple, simultaneous tasks effectively and efficiently while maintaining a professional, courteous manner
Must be able to work well with others
Strong verbal and written communication skills required
Must be detail oriented and organized
High integrity, including maintenance of confidential information
Must be able to exercise good judgment and positively influence and lead others, including handling confrontations with poise and efficiency
Based on business need, the ability to work a flexible schedule, including some evenings and weekends as approved in advance
We offer a comprehensive benefits package that includesfull Medical, Dental and Vision benefits effective on your first day of employment. A company matching401 K, tuition reimbursement, company paid Life Insurance and Long-term Disability, as well as generous PTO and Paid Holidays
If you are ready to join an exciting, progressive company and have a strong work ethic,join our team of experts!We offer a highly competitive salary and a comprehensive benefits package.
Envision Physician Servicesuses E-Verify to confirm the employment eligibility of all newly hired employees. To learn more about E-Verify, including your rights and responsibilities, please visitwww.dhs.gov/E-Verify
Envision Physician Services is an Equal Opportunity Employer.
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