Full Job Description
Schedule:
Full time
Shift:
Day (United States of America)
Address:
6061 S Willow Dr
City:
Greenwood Village
State:
Colorado
Postal Code:
80111
Job Description:
Analyzes managed care contracts to ensure compliance with organizational standards and regulatory requirements. Negotiates contract terms with payors to secure favorable reimbursement rates and conditions. Reviews and updates fee schedules and contract modifications to reflect current rates and terms. Communicates contract changes and updates to relevant internal departments and stakeholders. Collaborates with clinical and support staff to optimize reimbursement and reduce operational overhead. Monitors payor compliance with contractual obligations and addresses any discrepancies. Maintains accurate and up-to-date records of all managed care contracts and related documentation. Provides training and support to staff on managed care contract requirements and changes. Facilitates open communication and joint decision-making with payors and internal teams. Builds and maintains relationships with payors to ensure effective contract management. Resolves any issues or conflicts related to managed care contracts in a timely manner. Participates in performance improvement initiatives related to managed care processes. Other duties as assigned.Knowledge, Skills, and Abilities:
• General knowledge of healthcare, hospital and provider operations, and managed care payer contracts and operations. [Required]
• Must have a high degree of understanding of the managed care payers and managed care contracting requirements. [Required]
• Knowledge of healthcare, hospital/provider operations and managed care payer operations. [Required]
Education:
• Bachelor's [Preferred]
Field of Study:
• from a four-years college or university
Work Experience:
• 3+ years of managed care or position-related experience [Required]
• 5+ years of position-related experience [Preferred]
Additional Information:
• N/A
Licenses and Certifications:
• N/A
Physical Requirements: (Please click the link below to view work requirements)
Physical Requirements - https://tinyurl.com/23km2677
Pay Range:
$56,385.46 - $104,868.08