Managed Care Marketing Manager jobs in Gastonia, NC

 

Position is responsible for working with various internal and external customers regarding contract payor terms, policy/procedure updates, payor administration, variances/contract modifications, pricing updates, as well as anything that has an operational impact on the organization.  Strong analytical skills needed to compile and analyze data including: managed care denials/underpayment/ overpayment identification and resolution, contract modeling and evaluation, filing appeals as well as aiding in decision support reporting.  This position is responsible for day-to-day oversight of the contract compliance, payor relationships, co-ordination of payer onsite meetings and cross training with Provider Enrollment Specialist for credentialing and re-credentialing duties. Must work within contract language and have an understanding of healthcare reimbursement methodologies and language.  Majority of time will be spent working within Microsoft Excel, performing data analysis, tracking, trending and research.  Will also work with Contract Modeling software. 

 

Required Education: 

 

Associate’s degree from an accredited college or a minimum of four years’ experience with managed care contracting or payor relations. 

 

Required Work Experience: 

 

One year of applicable experience, if candidate has no experience they must have completed a successful healthcare or finance oriented internship with good references or an extensive managed care or an analytical background.