Consultant, Managed Care Policy, Baptist Health

Job Summary

Baptist Health is hiring a Managed Care Policy Consultant for our 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

Managed Care Policy Consultant, Job Responsibilities:

• Proactively identifies, analyzes and resolves payer contract, underpayments and policy discrepancies and initiates timely contract disputes to recover lost revenue.
• 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.
• Collaborate with internal departments, including Revenue Integrity, Billing, Patient Access, Operations and Finance to develop thorough responses to plans.
• Draft Notices and Formal Disputes to send to plans or government entities.
• 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.

Experience Requirements:

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

Education & Credential Requirements:

• Bachelor’s Degree
• Juris Doctor Preferred

If you are interested in this Managed Care Policy Consultant position at Baptist Health, please apply today!

Education Preferred

BS

Experience

• Revenue Cycle Experience
• Managed Care Experience
• Legal Experience

Location