Consultant, Managed Care Policy, Baptist Health

Job Summary

Baptist Health is hiring a Consultant, Managed Care Policy to join the Managed Care Team. This is a fully remote opportunity located in Jacksonville, Florida.

Approved work states: Alabama, Florida, Georgia, Idaho, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, Ohio, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Virginia, West Virginia and Wyoming

Responsibilities:

This role proactively identifies, analyzes and resolves payer contract, underpayments and policy discrepancies and initiates timely contract disputes to recover lost revenue. The role will investigate identified trends and payer issues to identify root causes and will develop solutions and communicate with internal and external contacts to resolve payer issues. The position will collaborate with internal departments, including Revenue Integrity, Billing, Patient Access, Operations and Finance to develop thorough responses to plans. The consultant will draft Notices and Formal Disputes to send to plans or government entities. This role will have a deep understanding of healthcare operations, contract law, and regulatory frameworks, and is detail-oriented, self-directed, and capable of managing multiple complex projects simultaneously.

*** JD Preferred

***7+ years experience in Legal, Revenue Cycle and Managed Care required.

If interested, please apply today.

Education Required

Bachelor's Degree

Education Preferred

Doctorate

Experience

• 7 + years Legal Experience Required
• 7 + years Revenue Cycle Experience Required
• 7 + years Managed Care Experience Required

License and Certification

None

Location

Location Overview

Baptist Health, founded in 1955, is North Florida’s most comprehensive health care system and the area’s only non-profit, mission-driven, locally governed health care provider. Baptist Health has over 200 points of care throughout the Northeast Florida region, including our six award-winning hospitals: Baptist Medical Center Jacksonville, Wolfson Children’s Hospital, Baptist Medical Center Beaches, Baptist Medical Center Clay, Baptist Medical Center Nassau and Baptist Medical Center South. The most preferred health care system in the region, Baptist Health also includes 57 primary care offices, as well as home health, behavioral health, pastoral care, rehabilitation services, occupational health and urgent care.