What are the responsibilities and job description for the Managed Care Contract Operations Manager - Remote position at Mercy?
We’re a Little Different
Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service.
At Mercy, we believe in careers that match the unique gifts of unique individuals – careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its “Top 100 Places to Work.”
Overview:
The Managed Care Contract Operations Manager is responsible for payor contract claims processing, payment terms, and conditions across the Ministry. This role involves ensuring compliance with contract terms, optimizing contract performance, and maintaining relationships with managed care organizations. Partnering with internal and external stakeholders in each community, this position will coordinate claims escalations and settlement processes to bring resolutions to escalated claims and settlement issues.
Qualifications:
Education: Bachelors degree in business, healthcare administration, computer science or a related field or equivalent experience in lieu of a degree as outlined below
Experience:
Three (3) years previous experience in healthcare, preferably with claims administration, either provider or health plan.
In lieu of degree, five (5) years previous experience in areas of managed care or healthcare operations, preferably with claims administration, either provider or health plan.
Other Skills, Knowledge, and Abilities: Able to independently handle multiple projects, coordinate analysis, and provide data tracking and documentation for resolution of escalated issues and the settlement process. Knowledge of managed care authorization, claims, and denials processes. Understand payor contract claims processing and payment terms and conditions.Preferred Experience: Clinical experience preferred.
We Offer Great Benefits:
Day-one comprehensive health, vision and dental coverage, PTO, tuition reimbursement and employer-matched retirement funds are just a few of the great benefits offered to eligible co-workers, including those working 32 hours or more per pay period!
We’re bringing to life a healing ministry through compassionate care.
At Mercy, our supportive community will be behind you every step of your day, especially the tough ones. You will have opportunities to pioneer new models of care and transform the health care experience through advanced technology and innovative procedures. We’re expanding to help our communities grow. Join us and be a part of it all.
What Makes You a Good Match for Mercy?
Compassion and professionalism go hand-in-hand with us. Having a positive outlook and a strong sense of advocacy is in perfect step with our mission and vision. We’re also collaborative and unafraid to do a little extra to deliver excellent care – that’s just part of our commitment. If that sounds like a good fit for you, we encourage you to apply.
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