Alliance HealthCare Services

  • Managed Care Contracts Administrator

    Job Locations US-AL-Muscle Shoals
    ID
    2019-14985
    Category
    Healthcare - Support Services
    Position Type
    full-time
  • About Us

    At Alliance HealthCare Services, our focus is on transforming the customer and patient experience. Vital to our success are the Corporate Team Members who collaborate with clinical, operational, and sales teams in the field. We focus on delivering improved processes, innovative new services, and business solutions that differentiate and advance our comprehensive clinical services—always with our patients’ and customers’ needs in mind.

    Job Responsibilities

     

     

    The Managed Care Contracts Administrator is responsible for the processing, from inception to the finished product, of a quotation to a managed care contract in accordance with Company policy as established by senior management.

     

    Specific duties include, but are not limited to:

    • Responsible for overall managed care contract administration from inception of quotation to final contract. Researches various leads to garner new contracts. Checks internet sites for managed care companies, contract administrators at various managed care companies, IPA/Medical groups, etc.
    • Contacts contract administrator at various managed care companies and/or IPA Medical Groups to solicit new business. May send out brochures/information describing current and/or new modalities.
    • Reviews initial contract from client. Ensures that all contract guidelines are verified and adhered to according to established guidelines. Performs minimal negotiation of rates and language with proposed payer.
    • Obtains final approval on all contracts from supervisor and/or General Counsel.
    • Tracks all contracts/addenda for complete and accurate terms, conditions and fees.
    • Obtains credentialing information for clincal and professional staff (i.e. radiologists, providers, etc.), and facilities as required by payers and regulatory compliance. Works with regions to gather information/application forms for accreditation or regulatory compliance.
    • Troubleshoots problems pertaining to contracts, claims or compliance issues.
    • Other duties as assigned.

    *LI-JR1

    Position Requirements

    • High School Diploma or equivalent experience required; Bachelor's Degree or equivalent experience preferred. 
    • Minimum 1 - 2 years related experience and/or training required. 

    A division of Alliance HealthCare Services, we are an equal opportunity employer and we believe in strength through diversity. All qualified applicants will receive consideration for employment without regard to, among other things, age, race, religion, color, national origin, sex, sexual orientation, gender identity & expression, status as a protected veteran, or disability.

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