What are the responsibilities and job description for the Managed Care Contract Specialist position at LHC Group?
Summary
The Managed Care Contract Specialist supports the Managed Care team.
Responsibilities
- Review contract terms and assist in analysis of reimbursement for Payor Contracts.
- Complete redlines on Payor Contracts and return to Payor for review.
- Prepare Contract Approval Form for internal circulation of new contracts.
- Notify Operations and Sales teams of contract terms once effective.
- Work with Revenue Cycle teams to resolve any issues arising from contracting issues.
- Ensure that all contracts are signed, shipped, countersigned and processed in a timely manner.
- Performs a variety of legal and analytic assignments under the direction of the SVP of Payor Strategy and Contracting Manager.
- Demonstrates a positive, flexible, customer comes first attitude.
- Manages special projects and perform other related duties as assigned.
- Prioritize and manage assignments quickly, accurately, and efficiently.
- Participates in and facilitate the preparation, execution, negotiation and administration of agreements, contracts and other managed care documents.
- Completes the pro forma and key terms sheet after SVP of Payor Strategy and Contracting Manager coordinate with Decision Support.
- Uphold strict confidentiality at all times regarding all managed care matters, including but not limited to pending and completed negotiations and acquisitions.
- Responsible for tracking all contracts, with particular emphasis on renewals and expiration's and keep internal clients and others informed of contract status and related issues.
- Maintain pending and completed contracts in an organized and accessible system.
- Assist with the load of all appropriate information in systems for the Revenue Cycle Department to access for eligibility/authorization/billing guidance.
- Prepares letters of Intent at the direction of the Contracting Manager.
- Manages RFPs at the direction of the Contracting Manager.
- Responsible for completing language changes at direction of Contracting Manager.
- Responsible for completing Key Terms worksheet based on pro forma information gathered prior to contract signatures.
- Attends conference calls as needed during contract negotiations.
- Responsible for completing termination letters as needed for contracts.
- Assists when needed to complete acquisition letters to send to payers.
- All other duties as assigned.
Education and Experience
- Formal Education: High School Diploma or equivalent
- College education preferred.
- Must be highly organized, efficient, and able to handle multiple tasks with ease and professionalism.
- Must possess administrative, analytical, problem-solving, and time management skills.
- Must have a thorough working knowledge of computers and applicable office software including Microsoft Office Suite (Adobe Professional, Outlook, Word, Excel, Access, Power Point), internet research, and database programs.
Company OverviewLHC Group is committed to a culture of diversity, equity and inclusion and is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any legally other protected characteristic.
LHC Group Inc Home Office a part of LHC Group family of providers – the preferred post-acute care partner for hospitals, physicians, and families nationwide. We deliver high-quality, cost-effective care that supports our patients when and where they need it. From our home health, hospice, and community-based services to inpatient care at our clinics and hospitals, our mission is to reach more patients and families with effective and efficient healthcare. More hospitals, physicians, and families choose LHC Group because we are united by a single shared purpose: It's all about helping people.
