Senior Managed Care Reporting & Contracts Lead

Epic Healthcare; Culver City (CA); Vor Ort; USD 95.000 - 135.000; Vollzeit

Zusammenfassung

Epic Healthcare in Culver City, CA is seeking a Managed Care Reporting & Contracts Specialist to oversee reporting, contracting, credentialing, and audits across MCPs and Medi‑Cal programs. You will coordinate with finance, operations, and leadership to ensure accurate data, timely submissions, and compliant processes.

The role requires strong Excel skills, attention to detail, and the ability to manage multiple deadlines while communicating effectively with external MCPs and internal teams.

Qualifikationen

• Experience in managed care, health plan operations, revenue cycle, quality, or similar healthcare environment.
• Strong working knowledge of Medi-Cal managed care, preferably with ECM, Community Supports, or similar programs.
• Demonstrated experience preparing complex recurring reports and submitting via portals or secure file transfer systems.
• High proficiency with Excel and other spreadsheet tools.
• Exceptional attention to detail and accuracy in data handling.
• Strong organizational skills with the ability to manage multiple deadlines and shifting priorities.
• Clear, professional written and verbal communication with County and MCP representatives and internal leaders.

Aufgaben

• Own the end-to-end production and submission of recurring County and MCP reports.
• Attend information sessions, sometimes in-person, to stay on top of developments.
• Maintain reporting calendars and trackers to ensure all reports are delivered on or before deadlines.
• Coordinate with internal departments to obtain accurate census and clinical/operational data for each report.
• Review, validate, and clean data prior to submission to minimize rejections and correction cycles.
• Submit reports through MCP portals and secure file transfer platforms according to plan specs.
• Manage correction files and return transmissions from MCPs and resubmit within required timelines.
• Track status of County and MCP contracts and lines of business by region.
• Prepare LOIs and provider information forms for new contracts and program expansions.
• Coordinate credentialing and certification process with MCPs, including collecting documents and timelines.
• Manage annual re-credentialing for all contracted MCPs.
• Support tax ID and NPI updates with MCPs and vendors.
• Submit County and MCP capacity reports and maintain provider directories.
• Monitor MCP surveys and network status checks in coordination with leadership.
• Coordinate and respond to audits and compliance documentation.
• Support with staff background verification and compliance requests.
• Monitor shared MCP inboxes and route authorizations and notices.
• Escalate urgent items to leadership and follow up until resolved.
• Assist with grants, special projects, and hospital reporting.

Kenntnisse

Excel proficiency

Data analysis

Communication skills

Organization

Attention to detail

Tools

Excel

Jobbeschreibung

Epic Healthcare in Culver City, CA is seeking a Managed Care Reporting & Contracts Specialist to oversee reporting, contracting, credentialing, and audits across MCPs and Medi‑Cal programs. You will coordinate with finance, operations, and leadership to ensure accurate data, timely submissions, and compliant processes.

The role requires strong Excel skills, attention to detail, and the ability to manage multiple deadlines while communicating effectively with external MCPs and internal teams.