Managed Care Specialist

Casa Colina Hospital and Centers for Healthcare

$80K — $110K *
Hospitals & Medical Centers
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Minimum 2 years of experience in hospital managed care negotiations
  • Strong verbal and written communication skills
  • Preferred experience in hospital billing
  • Preferred knowledge of the southern California payer market
  • Preferred proficiency in Excel and analytical skills

Responsibilities

  • Manage and negotiate hospital contracts with payers
  • Oversee all managed care contracts for the hospital and affiliated organizations
  • Assist in contract negotiations to enhance growth and profitability
  • Collaborate with various hospital departments and managed care payers
  • Verify correct insurer payments and escalate issues as needed

Benefits

  • Opportunities for professional growth and development
  • Collaborative work environment across various departments
  • Engagement with key players in the managed care market
  • Possibility of influencing contract negotiations for optimum results
Full Job Description
The Managed Care Specialist works with the Revenue Cycle Team to manage and negotiate hospital contracts. Responsible for all managed care contracts for the hospital and affiliated organizations. Assists in negotiating contracts to ensure the optimum balance of progressive growth and profitability. Coordinates closely with various hospital departments as well as the managed care payers. Verifies that insurers are paying correctly and escalates payment issues to payers.

The ideal candidate will possess the following:
  • At least 2 years' experience in hospital managed care negotiations
  • Excellent verbal and written communication skills
  • Hospital billing experience preferred
  • Knowledge of payer market in southern California preferred
  • Excel and analytical skills preferred


Salary Range = $80,000 to $110,000 based upon experience

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