Managed Care Operations Specialist

Job Type: Full-time

Pay: $31,627.00 - $52,000.00 per year

Location: Mostly remote, must be able to travel to our locations in Salisbury, Charlotte, and Greensboro

This is an exciting opportunity for a talented individual to join us as a Managed Care Operations Specialist on the Regional Management Team. You will be responsible for obtaining and providing subject matter expertise and technical assistance on matters related to Managed Care overseeing operations, policies, and regulations. The ideal candidate is a strategic thinker who is self-motivated and detail-oriented with a positive attitude, strong initiative, and ability to effectively communicate.

Duties & Responsibilities

• Provide consultation and advice to staff relating to the operations, policies, guidelines, and regulations of Managed Care Organizations (MCOs)
• Think strategically to advise on and implement operational best practices to provide value-based care to our beneficiaries in line with MCO network strategy
• Advise on the continued development of our thinkhealthdata.com technology platform to facilitate value-based care in line with MCO network strategy
• Educate and explain MCO related operations and policies and provides continuing education updates to staff relating to the Managed Care field
• Compile, maintain, and update various documentation and other reporting requirements
• Establish and maintain good communication, including appropriate written documentation, and rapport with internal staff and clients and with MCOs
• Oversee the billing processes to be submitted properly to MCOs according to appropriate guidelines, timelines, and deadlines
• Ensure overall satisfaction and success of projects while delivering exceptional service

Qualifications

• Ability to think strategically and successfully and collaboratively execute strategy
• Strong planning and project management skills with ability to wear many hats
• Reliable team player with a strong work ethic and a “can-do” attitude
• Customer centric with strong client service skills
• Ability to listen and communicate effectively and be be held accountable for work
• Experience with successfully identifying and resolving complex issues
• Demonstrated ability to establish and build rapport and good working relationships with management, colleagues, and third parties
• Experience with or ability to learn: Microsoft, Google Suite, Dropbox, and MCO platforms
• Must have a high school diploma - college degree preferred
• Home health or Health care experience preferred - experience with MCOs highly preferred

We seek an individual interested in growing with our company seeking long-term employment. Salary will be based on experience. Benefits are included.