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Transplant Contract Specialist Managed Care
- AdventHealth (Maitland, FL)
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Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that **together** we are even better.
All the benefits and perks you need for you and your family:
+ Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
+ Paid Time Off from Day One
+ 403-B Retirement Plan
+ 4 Weeks 100% Paid Parental Leave
+ Career Development
+ Whole Person Well-being Resources
+ Mental Health Resources and Support
+ Pet Benefits
Schedule:
Full time
Shift:
Day (United States of America)
Address:
2600 LUCIEN WAY
City:
MAITLAND
State:
Florida
Postal Code:
32751
Job Description:
+ Participates in negotiation planning and development projects to support strategic alignment with contracted health plans.
+ Seeks resolution to managed care issues by collecting and interpreting contract performance information to preserve the integrity of those contracts.
+ Supports the timely start of contract negotiation activities by compiling information through research and coordination with departmental leaders.
+ Maintains and negotiates contracts with external community provider groups to provide transplant services under AdventHealth global transplant contracts.
+ Maintains Global Spreadsheet, capturing Solid Organ and Bone Marrow Transplant information.
+ Corresponds with payer survey contact as needed and ensures any additional information requested by payer is provided in a timely manner.
+ Assists with appeals and disputes of outcomes then reviews and forwards the decisions of these outcomes.
+ Assists with resolving payment issues during the global billing period and ensures payments are made appropriately.
+ Other duties as assigned.
Knowledge, Skills, and Abilities:
• Typing:35 wpm [Required]
• Spreadsheet experience [Required]
• Email and computer calendar experience [Required]
• Detail oriented [Required]
• Assertive [Required]
• Read and understand contracts effectively [Required]
• Ability to problem solve and think analytically [Required]
• Strong organizational skills [Required]
• Effectively communicate with all department levels [Required]
• Ability to grow strong relationships [Required]
Location and Shift:
+ Hybrid- Monday, Wednesday, Thursday onsite) Maitland, FL
+ Full Time M-F 8am-5pm
Education:
• Bachelor's [Preferred]
Field of Study:
• in Business or Healthcare Administration or related field
Work Experience:
• 4+ years of experience in managed care or healthcare provider relations experience [Required]
• 5+ years in healthcare or insurance [Preferred]
• Experience in managed care contract negotiations for hospital, transplant and global services [Required]
• Healthcare billing experience [Preferred]
• Managed Care contract experience [Preferred]
Additional Information:
• N/A
Licenses and Certifications:
• N/A
**Physical Requirements:** _(Please click the link below to view work requirements)_
Physical Requirements - https://tinyurl.com/23km2677
Pay Range:
$49,718.59 - $92,468.74
_This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances._
**Category:** Revenue Cycle & Managed Care
**Organization:** AdventHealth Corporate
**Schedule:** Full time
**Shift:** Day
**Req ID:** 150660955
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Transplant Contract Specialist Managed Care
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