Description
We are searching for a candidate for a Managed Care Contract Specialist opportunity in Houston TX.
Reports To
Director, Managed Care System Operations
Salary range
$104,780.00 to $135,563.00
Must-Haves
Hospital Contract Modeling
Third Party Payer Negotiation
Literacy with health insurance plans
Payment Integrity Compass or Epic experience
Job Description Summary
Responsible for building, loading, testing, and maintaining hospital third-party payer contracts in the contract modeling system. Accountable for analyzing relevant data and translating into reporting to support necessary determinations of adjustment to ensure maximization of values for contract negotiation purposes, and ultimately final agreed reimbursement, meeting System financial and operational expectations. Participates in active third-party payer negotiation discussions representing modeling work product through necessary iterations of rate modeling and analysis.
MINIMUM QUALIFICATIONS
Education:
Bachelor’s degree in business administration, Finance, or Accounting preferred.
Licenses/Certifications: Required to complete training and become certified in the applicable EPIC applications within the first 90 days of employment to include Resolute Hospital Billing Expected Reimbursement Contracts Administration.
Experience / Knowledge / Skills:
Three (3) years’ experience in hospital contract modeling required (preferably in Payment Integrity Compass (PIC) or Epic).
Effective oral and written communication skills.
Ability to analyze, problem solve and apply critical thinking in a fast-paced environment.
Strong organizational skills with the competency to work independently as well as part of a team, and prioritize responsibilities.
Must possess proficient Excel skills (i.e. pivots, v-lookup functions).
Benefits
Dental Insurance
Medical Insurance
Vision Insurance
Life Insurance
Retirement
Equity
Work From Home
Paid Time Off
Other
LP