Serve as primary point of contact with assigned managed care companies on all negotiating and operational issues. Responsible for monitoring contracts' financial performance as well as payor compliance with all terms and conditions. Upholds positive relations with payors and internal customers, including revenue cycle, legal, clinic/hospital operations and providers. Facilitates problem resolution, communication flow and education while also maintaining appropriate documentation of issues and activities.
Job Opening Qualifications
Minimum Education and Experience Requirements:
Bachelor's degree in business or a health care-related field required.
Advanced managed care experience may substitute for the degree on a year-by-year basis.
Requires two years in managed care industry experience in at least two of the following areas: contract language review, financial negotiation of hospital and physician contracts, provider relations, revenue cycle, financial or reimbursement analysis, NCQA/HEDIS requirements, AHCA/CMS regulations, utilization review/management, member services or account/service management (marketing).
Master's degree may substitute for the required experience on a year-by-year basis.
Prefer three to five years of managed care experience.
We invite you to join our team! Our work and passion for excellence are intended to have an impact beyond the communities in which we serve. You may apply for a maximum of 10 positions at any given time. For general application process topics please review our Frequently Asked Questions. For technical assistance please contact Human Resources at 352-265-0441.
UF Health Shands Hospital is committed to diversity as a competitive advantage in attracting top talent from across the nation and around the world. We believe in sharing knowledge, learning from one another, valuing different opinions, and celebrating the things that make each one of us unique in our own right. UF Health Shands Hospital is an equal opportunity employer and drug-free workplace. Equal Opportunity Employer M/F/D/V