Under the general supervision of the Director Payer Contracting and Analytics, the Managed Care Specialist will work to achieve the objectives of the department including managed care contracting, financial analysis, charge capture, process improvement, project management, and staff education for specific service lines and supporting departments (revenue centers) through the organization and its affiliates. Additionally, the Managed Care Specialist will serve as a point of contact for external insurance plan representatives. Key responsibilities include interacting with Managed Care stakeholders, supporting and understanding clinical and billing processes, identifying and improving processes to allow capturing of all charges and billing for services being providing, educating and communicating with staff regarding processes, auditing and reporting outcomes of the processes, and utilizing all internal and external resources in order to accomplish and sustain improvements.
The Managed Care Specialist is expected to independently lead projects and produce measureable sustained outcomes. Using national best practices, this position proactively implements and supports system Managed Care/Payer Contracting improvements.
Minimum Knowledge, Skills and Experience required:
Education:
Bachelor's in Business Administration, Health Administration, or Clinical Discipline. RN Preferred.
Bachelor's Degree in Accounting, Finance, or Business field or comparable combinations of education and/or experience will be considered.
Experience:
At least 3 years experience working with managed care contracting, patient accounting, case management, internal audit, coding, and/or process improvement. Combination of work and educational record that demonstrates knowledge of:
Additional Skills/Abilities:
Word, Excel, PowerPoint, Access, and working within a networked IT system
Highlights of our hospitals
Huntsville Hospital was recently named Best Regional Hospital and #2 in Alabama by U.S. News & World Report. With 971 beds, a specialized Orthopedic & Spine Tower, a Level III Regional Neonatal ICU, and the largest Emergency Department and Level 1 Trauma Center in the state with our own specialized Red Shirt Trauma Program, there are many opportunities to apply your knowledge and skills. We are a certified Primary Stroke Center and named \"One of the Top 100 Hospitals in the Nation with Great Heart Programs.\" From six cath labs and four EP labs to multiple medical and step-down units, you can continually grow your skillset! We offer a training center on campus for continuing education, Shared Governance Program, Clinical Ladder for professional development, The Daisy Award, and if you are a new grad, a Nurse Residency Program to help you transition from student to professional nurse. We care about you and your well-being by offering an excellent benefits package, childcare, health and wellness programs, an onsite employee pharmacy, a free health clinic, tuition assistance, and much more. We are committed to creating a diverse environment and proud to be an equal opportunity employer. We are a partner to the U.S. Army’s Partnership for Your Success (PaYS) program.
Ask us about incentives and additional opportunities.
Huntsville Hospital Benefits:
We are committed to providing competitive benefits. Our benefits package for eligible employees includes medical, dental, vision, life insurance, flexible spending; short term and long term disability; several retirement account options with 401K organization match; nurse residency program; tuition assistance; student loan reimbursement; On-site training and education opportunities; Employee Discounts to phone providers, local restaurants, tickets to shows, apartment application and much more!
Learn more about Huntsville Hospital Health System:
Careers: https://careers.hhsys.org/careers-homeBenefits: https://careers.hhsys.org/us/en/benefitsEducation & Professional Development: https://www.huntsvillehospital.org/educationLife In Huntsville: https://www.huntsvillehospital.org/about-huntsville-al