Note: The job is a remote job and is open to candidates in USA. Blue & Co., LLC is a dynamic professional services firm specializing in accounting and consulting services, particularly in the healthcare sector. They are seeking a Managed Care Specialist to provide expertise in Managed Care contracts and operational best practices, working closely with healthcare providers and the firm's Revenue Cycle teams.
Responsibilities
- Read and interpret Managed Care contract terms, payment logic, and hierarchies to assess risks and to determine opportunity areas of focus for healthcare providers
- Interview provider personnel to obtain additional information on insurance carrier relationships and historical reimbursement trends
- Work with clients to articulate issues requiring attention and develop processes and work plans to address identified issues
- Assist clients with the negotiation of contracts, identifying and prioritizing clients’ underlying needs and goals in order to achieve a positive outcome for the client
- Develop and maintain personal relationships with payors and providers that engender cooperation and trust, and are conducive to 'win-win' scenarios
- Review, test, and analyze large utilization data sets from healthcare providers
- Oversee and prepare financial models utilizing various database software systems
- Development of exhibits and narrative reports outlining our analysis & reimbursement impacts
- Daily verbal and written communication with healthcare providers & health plans
- Review insurance contracts, applicable state laws and other financial documentation to determine the proper advice back to clients
Skills
- 2-6 years of Managed Care related experience that includes the review and negotiation of payor contracts
- Understanding of contract language and Managed Care contract modeling
- Basic understanding of the fundamentals of Values-Based Contracting
- Strong analytical skills; exceptional attention to detail and demonstrated ability to prioritize tasks to ensure accuracy and timely completion
- Investigational and analytical skills with a proven ability to communicate effectively in both written and verbal format with internal and external clients
- Strong organization and documentation skills
- Advanced skills in MS Excel, Word, and various database programs
- Ability to work autonomously and thrive in a fast-paced environment with shifting priorities
- Advanced interpersonal skills, including the ability to listen productively, to motivate, and to persuade
- The successful candidate should be comfortable interacting with senior executives, both those internal to Blue & Co., and those who are employed by clients and payors
- Successful candidate should be skilled at organizing and leading professional business meetings
- Selected applicant should be proficient at delivering oral presentations
- Candidates must be authorized to work in the U.S. without current or future employer sponsorship
Company Overview
At Blue & Co. It was founded in 1970, and is headquartered in Bloomington, Indiana, USA, with a workforce of 201-500 employees. Its website is https://www.blueandco.com/.
