Single Case Agreement - SCA Consultant

Hsp Inc; Los Angeles (CA); On-site; USD 129,000 - 174,000; Full time

Job summary

Healthcare Staffing Professionals is seeking an SCA Consultant to lead payer negotiations and establish a sustainable SCA workflow. The role involves creating standardized requests, tracking, and coordination with private health plans to secure in-network rates for TB-related services.

The position is hybrid, located in Downtown LA, with a 40-hour work week and immediate start on a funded project through 6/30/27, with potential extension.

Qualifications

• Experience negotiating payer contracts and SCAs with health plans.
• Ability to build standardized SCA workflows and tracking systems.
• Experience with public health reimbursement processes a plus.

Responsibilities

• Build standardized SCA requests and tracking system with health plans.
• Enable Public Health to capture reimbursement for TB services.
• Transition SCA workflow to permanent Public Health operations and train staff.

Skills

Payer negotiation

Healthcare contracts

Private health plans

Stakeholder coordination

Job description

Healthcare Staffing Professionals has an immediate need for a Single Case Agreement - SCA Consultant.Payer negotiation and single-payer strategy jobs involve managing managed-care contracts, negotiating reimbursement rates, or facilitating Single Case Agreements (SCAs) between medical providers and insurance companies.

The positions will start immediately upon acceptance and employment clearance and are initially funded through 6/30/27, with the high chance of extension.

Pay Rate: $72.71/hr working 40 hours a week

Location: Full Time - hybrid schedule, working in Downtown LA | approximately 3 days inoffice (Wednesday as 1 of the days) and occasional field work meeting with stakeholders or insurance companies.

Healthcare: Employer Fully Funded Healthcare (options are: Anthem & Kaiser), Dental and Vision, Life Insurance from Initial

Objective 1is toestablisha sustainable Single Case Agreement (SCA) workflow.

• will builda standardizedrequest and asystem for tracking, and managing Single Case Agreements with health plans

Objective2is to enable Public Health to capture reimbursement for TB services already being provided.

• willobtain SCAauthorizationsand successfully bill private health plans for TB clinical services that are currently unreimbursed due to out-of-network status.

Objective3is to transition the process to permanent Public Health operations.

• will trainourexistingstaff and operationalize theworkflowso the process continues without consultant support and becomes part of routine revenue cycle management.

Some info to try to define what SCAs are and their uses:

• Single Case Agreements - A temporary contract between an insurance company and an out-of-network provider.
• SCA – Allows patients to receive specialized care at in-network costs, often when no suitable in-network providers exist or for continuity of care when insurance changes

One of the key requirements we need from this consultant/contractor is experience with working with private health plans, and possibly have connections with the health plan's utilization management.

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, sexual orientation, gender identity, or any other characteristic protected by law.

TrueBlue, Inc. And its brands welcome and encourage applications from candidates with disabilities. Accommodations are available upon request for candidates taking part in the application or interview process. TrueBlue, Inc. And its brands will consult with all applicants who request disability-related accommodation during the application or interview process to ensure that the accommodation provided takes into account the applications individual accessibility needs.

We consider qualified applicants with arrest and conviction records in accordance with applicable law.