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Managed Care Specialist
Advocate Aurora Health. Manages administration of the assigned portion of the contract portfolio .
About the role
Key responsibilities & impact- Manages administration of the assigned portion of the contract portfolio
- Maintains detailed working knowledge of assigned payor contracts and manages managed care contract administration and compliance activities
- Creates and maintains electronic document databases and original permanent files for contract documents
- Communicates and educates operational implementation of new contract terms affecting revenue cycle functions
- Manages implementation of new or renegotiated managed care agreements
- Manages secure distribution of confidential contract documents and communicates contract changes to executives and revenue cycle personnel
- Monitors, reports, resolves, and prevents operational issues related to existing managed care contracts
- Interacts with revenue cycle staff and MCO provider relations to resolve operational issues
- Serves as advisor and point of contact for revenue cycle personnel on managed care operational and administrative issues
- Supports designated teammates and Managed Health Resources Provider Services in operational roles
- Initiates and facilitates Joint Operating Committee meetings with MCOs and internal issue-resolution meetings
- Coordinates meetings, prepares agendas, creates performance reports, and distributes meeting minutes
- Reviews payor websites and external information to stay current on payor policies and initiatives
- Prepares clear, concise internal communications and correspondence
- Determines data sources, performs analyses, and applies methodologies under supervision
Requirements
What you’ll need- Fulltime, Dayshift Monday - Friday
- Fully Remote Role from these states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY
- No relocation and no sponsorship or transfer of visa for this position now or in the future
- Associate's degree or equivalent experience required
- Minimum two years experience in managed care contracting, operations, or patient financial services for large healthcare provider or managed care organization
- Experience preparing, processing, and tracking formal business correspondence and contract notifications, including time-sensitive mailed and electronic communications
- Strong research and analytical skills, with the ability to identify discrepancies and follow issues through resolution
- Experience managing multiple projects, deadlines, work queues, or high-volume administrative assignments
- Licensure, Registration, and/or Certification: None Required
- Ability to perform work under normal office conditions, including sitting for long periods, standing, walking, repetitive wrist/arm motion, or lifting articles up to twenty-five pounds
Benefits
Comp & perks- Benefits Eligible
- Competitive compensation
- Premium pay such as shift, on call, and more based on a teammate's job
- Incentive pay for select positions
- Opportunity for annual increases based on performance
- Paid Time Off programs
- Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
- Flexible Spending Accounts for eligible health care and dependent care expenses
- Family benefits such as adoption assistance and paid parental leave
- Defined contribution retirement plans with employer match and other financial wellness programs
- Educational Assistance Program
- Fully remote role
- Monday–Friday dayshift schedule