Managed Care Consultant
Mercy
full-time
Posted on:
Location Type: Remote
Location: Montana • Oklahoma • United States
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About the role
- knowledge of managed care contracting language, requirements, and methods to support the development and maintenance of contract compliance
- contract language review and contract analysis
- strong analytical mind, with problem-solving skills, an aptitude for accuracy, and attention to detail
- knowledgeable about the managed care environment, including capitation, PPO, HMO, IPA, ACO, fee for service and value base agreements
- Experience in successful operationalizing managed care contracts
Requirements
- Minimum Required Education: Bachelor's Degree in Business Administration, management or healthcare-related field
- Experience: A minimum of 3 years' experience in or working with Managed Care
- Strong working knowledge of health plan business functions and activities
- Strong analytical and problem-solving skills
- Demonstrated ability to work independently and manage multiple projects simultaneously
- Strong oral and written communication skills; ability to interact within all levels of the organization
- Ability to structure and visualize information to drive decision-making and execution
- Familiarity with healthcare, particularly Medicaid, Commercial and/or Medicare managed care
Benefits
- medical, dental, and vision coverage
- paid time off
- tuition support
- matched retirement plans for team members working 32+ hours per pay period
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
contract language reviewcontract analysismanaged care contractingoperationalizing managed care contractshealth plan business functionscapitationPPOHMOIPAACO
Soft Skills
analytical skillsproblem-solving skillsattention to detailindependent workproject managementoral communicationwritten communicationinterpersonal skillsdecision-makinginformation visualization
Certifications
Bachelor's Degree in Business AdministrationBachelor's Degree in managementBachelor's Degree in healthcare-related field