Managed Care Contracts Manager id-10313 id-10313
đź“‹ Description
•This role is responsible for the more complex and large account negotiations, preparation, financial analysis, business review, and implementation of assigned Managed Care clients, 340B, and Health System Partnership agreements for home and alternate site infusion services provided by Option Care. •Responsible for managed care plans with greater than 250K lives that require more complex negotiation and relationship management. •Resolve reimbursement issues arising from contract compliance issues for assigned regions when escalated by Revenue Cycle Management team. •Manage the negotiation of managed care and health system contracts in accordance with company guidelines for assigned geography for home and alternate site infusion therapy services provided by Option Care. •Oversee internal implementations of assigned agreements with regional intake, operations, and revenue cycle teams in order to insure success of clean claims payment. •Manage external implementations and foster ongoing relationships with assigned accounts. •Manage communication with assigned accounts as it relates to demographic changes to Option Care Facilities to insure health plan agreements are current in order to facilitate clean claim billing. •Initiate and lead meetings with health plans and corporate teams, including Managed Markets and Contracting leadership, to review provider agreement performance data and scorecards. •Informs contracting leadership of contract risks for assigned third party contracts. •Recommends course of action to reduce/minimize risk to the organization. •Identifies, and assesses impact of potential changes in the industry or changes related to new state or federal legislation. •Resolve reimbursement issues identified by Payer Liaisons that may be related to contract compliance. •Strategize with AVP MMS on plans to update and grow a sales representative’s understanding of the scope and intent of assigned managed care or facility contracts. •Attends client meetings where appropriate and in collaboration with assigned managed markets representative.Virtual Assistant, $40/hr, Evening, Remote, No Degree Virtual Assistant, $40/hr, Evening, Remote, No Degree Customer Support, $40/hr, Remote, Part-Time, No Degree Virtual Assistant, $50/hr, Remote, Part-Time, Evening Job Entry-Level Remote Data Entry, $50/hr, Evening Job Remote Customer Support, $45/hr, Part-Time, College Student Weekend Data Entry, $40/hr, Remote, No Experience Live Chat Support, Remote, $42/hr, Night Shift, College Student Remote Customer Support, $40/hr, No Experience, Part-Time Customer Support, No Degree, $40/hr, Remote, Weekend Job Phone Support, Remote, $42/hr, Evening/Night Shift Phone Support, $50/hr, Weekend, Remote, No Experience Phone Support, Remote, $35/hr, No Experience, Part-Time Virtual Assistant, Remote, $50/hr, Part-Time, Night Shift Virtual Assistant, $45/hr, Remote, No Experience, Night Job Virtual Assistant, $40/hr, Weekend, Remote, No Experience Virtual Assistant, Remote, $35/hr, Part-Time, Night Shift Customer Support, $35/hr, Remote, Evening/Night Job, No Degree Remote Customer Support, $45/hr, No Degree, Evening Job Phone Support, Remote, $50/hr, No Experience, Night Shift Remote Live Chat, $40/hr, Part-Time, No Degree Required Data Entry, $35/hr, Night Shift, No Degree,?Remote?Job Remote Phone Job, $50/hr, College Student, Night Shift Remote Customer Support, $45/hr, No Experience, Part-Time Remote Customer Support, $40/hr, Weekend, No Experience Remote Phone Support, $45/hr, Evening, No Experience Required Remote Data Entry, $40/hr, Part-Time, No Degree Required Remote Phone Support, $45/hr, Night Job, College Student Remote Phone Job, $45/hr, No Degree, College Student Friendly Data Entry, $40/hr, Remote, Night Job, No Degree Remote Customer Support, $45/hr, No Degree, Evening Job Remote Phone Job, $40/hr, Part-Time, No Experience Required Remote Phone Job, $45/hr, Part-Time, No Degree Required Remote Customer Support, $45/hr, Part-Time, College Student Remote Data Entry, $40/hr, Weekend Job, College Student Live Chat Support, $40/hr, Weekend, Remote, College Student Remote Data Entry, $50/hr, No Experience, Evening/Night Job Remote Phone Support, $40/hr, Evening, No Experience Required Live Chat Support, $45/hr, Part-Time, Remote, No Degree Virtual Assistant, $40/hr, Remote, Weekend, No Degree Virtual Assistant, $40/hr, Remote, No Degree, Night Job Virtual Assistant, $42/hr, Evening, Remote, No Degree Remote Moderator, $40/hr, College Student Friendly, Part-Time Entry Level Phone Job, $42/hr, Remote, No Degree Required Data Entry, No Experience, $50/hr, Remote, College Student Live Chat Support, $45/hr, Part-Time, Remote, No Degree Remote Phone Support, $40/hr, Night Job, College Student Remote Phone Job, $45/hr, No Degree, College Student Friendly Remote Moderator, $45/hr, No Degree, Weekend Job, Part-Time Data Entry, $35/hr, Night Job, No Degree, Remote Entry Level Phone Job, $42/hr, Remote, No Degree Required Remote Phone Job, $40/hr, Part-Time, No Degree Required Remote Phone Job, $50/hr, College Student, Night Shift Data Entry, Remote, $40/hr, Evening Job, No Degree Data Entry, $40/hr, Remote, Night Job, No Degree Live Chat Support, $45/hr, Part-Time, Remote, No Degree Data Entry, Remote, $40/hr, Night Shift, No Degree Phone Job, $50/hr, Remote, No Degree, Part-Time, Weekend Data Entry, $45/hr, Remote, Night Job, No Degree Live Chat Support, $40/hr, Part-Time, Remote, No Degree Remote Live Chat, $40/hr, Part-Time, No Degree Required Virtual Assistant, $40/hr, Remote, No Degree, Night Job Phone Job, $35/hr, Remote, Part-Time, College Student Remote Data Entry, $40/hr, Part-Time, No Degree Required Phone Job, $40/hr, Remote, Night Shift, No Degree •Maintains successful working relationships with internal departments such as Infusion Operations, Legal, Sales, and any other departments that are involved with or impacted by managed care contracts. •Complete credentialing applications when necessary for new contract access as back up to contract coordinator. •Participate in regional meetings as directed by VP, Contracting.
🎯 Requirements
•High school diploma and 10yrs of experience in managed care account management or contract analysis and negotiation within the health care industry. •Experience with contract negotiations involving financial terms for health care services. •Experience in working with managed care clients and familiarity with contract terms and conditions in the ancillary arena. •Experience with analyzing and reporting data in order to identify issues, trends, or exceptions to drive improvement of results and find solutions. •Experience providing customer service to internal and external customers, including meeting quality standards for services. •Experience with Home Infusion or Specialty pharmacy •Experience with CPR+ preferred •Experience using time management skills such as prioritizing/organizing and tracking details and meeting deadlines of multiple projects with varying completion dates. •Intermediate level skill in Microsoft Excel (for example: using SUM function, setting borders, setting column width, inserting charts, using text wrap, sorting, setting headers and footers and/or print scaling). •Intermediate level skill in Microsoft PowerPoint (for example: applying a theme, formatting character spacing, inserting a picture, changing slide layout and theme colors, adding transitions, customizing slide numbers, changing chart style and/or formatting font). •Intermediate level skill in Microsoft Word (for example: inserting headers, page breaks, page numbers and tables and/or adjusting table columns).
🏖️ Benefits
•401k •Dental Insurance •Disability Insurance •Health Insurance •Life Insurance •Paid Time off •Vision Insurance
