Managed Care Coordinator jobs in Milwaukee, WI

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Location: US:WI:MENOMONEE FALLS at our WOODLAND PRIME 400 facility.

This job is HYBRID.

FTE: 1.000000

Shift: 1st shift 8 am to 4:30 pm onsite Tuesday and Wednesday then work from home Monday Thursday, and Friday.

Job Summary:
The Managed Care Contract Coordinator acts as a liaison with managed care organizations (e.g., networks, insurers) and with internal customers, such as Patient Financial Services and Quality, to resolve issues related to reimbursement and managed care requirements. Other duties as assigned.

The Managed Care Contract Coordinator manages the contracts with the insurance payers for the entire FH system. The position:

*Works as a liaison by presenting contract summaries to the organization to explain contract reimbursement and contract terms to internal constituents.

*Consults with clinical and business units to assess if contract terms are being followed.

*Identifies new contracting opportunities for strategic growth.

*Assists to negotiate reimbursement and language of payer contracts.

*Addresses operational issues and provides contract language to support appeals to the Payer.

*Establishes productive personal relationships with payer representatives and internal clinical/business staff.

*Ensure all documents associated with the negotiation payer agreement are in appropriate system accurately and performs audits on a regular basis to ensure accuracy.

*Other duties as assigned.

EXPERIENCE DESCRIPTION:

Three to five years of experience in a Health Care setting in either the payer or provider environment.

Demonstrated ability in resolving complex issues is required.

Bachelor's degree in Business, Finance, Accounting or related field is required. In lieu of degree will consider 7 years of health care experience.

Knowledge of managed care principles and the insurance industry is required.

Ability to take initiative and exercise independent decision making.

Strong communication skills and strong organizational skills are essential.

Project management experience and strong PC skills including database management, spreadsheets and SharePoint editor.

Managed care certification is preferred.

Perks & Benefits at Froedtert Health

Froedtert Health Offers a variety of perks & benefits to staff, depending on your role you may be eligible for the following:

• Paid time off
• Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities
• Academic Partnership with the Medical College of Wisconsin
• Referral bonuses
• Retirement plan - 403b
• Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics
• Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available

The Froedtert & the Medical College of Wisconsin regional health network is a partnership between Froedtert Health and the Medical College of Wisconsin supporting a shared mission of patient care, innovation, medical research and education. Our health network operates eastern Wisconsin's only academic medical center and adult Level I Trauma center engaged in thousands of clinical trials and studies. The Froedtert & MCW health network, which includes ten hospitals, nearly 2,000 physicians and more than 45 health centers and clinics draw patients from throughout the Midwest and the nation.

We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce. We welcome protected veterans to share their priority consideration status with us at 262-439-1961. We maintain a drug-free workplace and perform pre-employment substance abuse testing. During your application and interview process, if you have a need that requires an accommodation, please contact us at 262-439-1961. We will attempt to fulfill all reasonable accommodation requests.