Managed Care Specialist

Welcome to Atrium Health, where we are committed to providing exceptional care to our patients and communities. We are currently seeking a highly motivated individual to join our team as a Managed Care Specialist. In this role, you will play a vital role in managing and negotiating contracts with insurance providers to ensure the best possible outcomes for our patients and organization. We are looking for someone with a strong understanding of managed care principles and a passion for delivering high-quality healthcare. If you are a detail-oriented, strategic thinker with excellent communication and analytical skills, we encourage you to apply for this exciting opportunity.

1. Negotiate and manage contracts with insurance providers to ensure optimal reimbursement rates and coverage for our patients.
2. Monitor and analyze healthcare market trends to inform contract negotiations and identify potential opportunities for cost savings.
3. Develop and maintain relationships with insurance providers, advocating for the needs of our patients and organization.
4. Collaborate with internal teams, including finance and operations, to ensure compliance with contract terms and facilitate timely and accurate reimbursement.
5. Stay up-to-date on industry regulations and changes in managed care policies, adjusting negotiation strategies as needed.
6. Conduct cost-benefit analyses and make recommendations for contract renewals or new partnerships.
7. Serve as a subject matter expert on managed care principles and educate colleagues on best practices.
8. Communicate contract updates and changes to relevant stakeholders within the organization.
9. Monitor and track contract performance, identifying and addressing any issues or discrepancies.
10. Maintain accurate and organized records of contract negotiations, agreements, and correspondence with insurance providers.
11. Work closely with billing and coding teams to ensure accurate and timely submission of claims.
12. Provide exceptional customer service to insurance providers, addressing any inquiries or concerns in a timely and professional manner.
13. Collaborate with cross-functional teams to identify areas for process improvements related to managed care contracts.
14. Adhere to all ethical and legal standards in managing contracts and handling sensitive patient information.
15. Continuously evaluate and recommend strategies to improve managed care processes and outcomes.

According to JobzMall, the average salary range for a Managed Care Specialist in Charlotte, NC, USA is $58,000 - $72,000 per year. This can vary depending on factors such as experience, education, and the specific company or organization the specialist is working for.

Atrium Health, formerly Carolinas HealthCare System, is a not for profit hospital network which operates hospitals, freestanding emergency departments, urgent care centers, and medical practices in the American states of North Carolina, South Carolina and Georgia.