Managed Care Specialist

Casa Colina; Pomona (CA); On-site; USD 80,000 - 110,000; Full time

Job summary

Casa Colina in Pomona seeks a Managed Care Specialist to oversee and negotiate hospital contracts. The ideal candidate has at least 2 years of experience in hospital managed care negotiations and excellent communication skills. Responsibilities include managing all managed care contracts, ensuring correct payments from insurers, and coordinating with various departments. A salary range of $80,000 to $110,000 is offered based on experience.

Qualifications

• At least 2 years’ experience in hospital managed care negotiations.
• Excellent verbal and written communication skills.
• Hospital billing experience preferred.
• Knowledge of payer market in southern California preferred.
• Excel and analytical skills preferred.

Responsibilities

• Work with the Revenue Cycle Team to manage and negotiate hospital contracts.
• Responsible for all managed care contracts for the hospital and affiliated organizations.
• Assist in negotiating contracts for growth and profitability.
• Coordinate with various hospital departments and managed care payers.
• Verify correct insurer payments and escalate issues as needed.

Skills

Hospital managed care negotiations

Verbal communication skills

Written communication skills

Excel skills

Analytical skills

Job description

The Managed Care Specialist works with the Revenue Cycle Team to manage and negotiate hospital contracts. Responsible for all managed care contracts for the hospital and affiliated organizations. Assists in negotiating contracts to ensure the optimum balance of progressive growth and profitability. Coordinates closely with various hospital departments as well as the managed care payers. Verifies that insurers are paying correctly and escalates payment issues to payers.

Ideal Candidate

• At least 2 years’ experience in hospital managed care negotiations
• Excellent verbal and written communication skills
• Hospital billing experience preferred
• Knowledge of payer market in southern California preferred
• Excel and analytical skills preferred

Salary Range = $80,000 to $110,000 based upon experience