Medical Contracting Specialist, Full Time Position - Aurora, United States - Managed Care Staffers

Description

JOB LISTING:
Medical Contracting Specialist, Full Time Position – Aurora, IL '

Medical Contracting Specialist

, Regular Full-Time position (Aurora, IL)

Our client a busy and growing Union Health & Welfare Fund located in Aurora, IL, has an immediate staffing need for an experienced, full-time Medical Contracting Specialist.

This position is a direct hire, mostly remote position with an occasional requirement to come to the office in Aurora, IL.

This position comes with highly competitive pays and a very generous benefits package. You must be Covid vaccinated.
Purpose of Position

The Medical Contracting Specialist role functions as the main point of contact between the operational departments of our organization and a wide range of managed care vendors and providers.

This position works closely with internal departments to help identify and resolve issues, implement new benefit platforms, and overall guide the relationship between our company and our service provider partners.

The MCS supports the organization Leadership in holding vendors accountable for providing the highest level of services at the lowest cost to our organization and its members.

The Managed Care Specialist will work towards becoming a subject matter expert on the vendor relationships they are responsible for overseeing.

Essential Job Functions and Duties
Negotiates renewals with vendors and services providers and works to capture key initiatives

Builds relationships with contracted providers and managed care vendors to facilitate problem identification and resolution, set expectations and evaluates performance.

Thoroughly reviews and edits service provider contracts accordingly.
Coordinates and ensures compliance with the Fund's vendor monitoring policy.
Works with vendors and staff to assist in implementation projects and other projects
Designs and develops benefit and/or provider/managed care vendor analysis reports on a regular basis
Analyzes and drafts data and resolutions for Board of Trustees
Contributes ideas to plans and achieving department goals
Years of Experience and Knowledge
3-5 years of contracting with medical provider and managed care vendors
3~5years of direct experience working in employee health benefits administration, provider relations or a related field.
Working knowledge and experience in analyzing healthcare plans and/or employee benefits
Working knowledge and experience in health ins., managed healthcare & medical claims processing
Education, Licenses, and Certifications
Bachelor's degree in Business, Healthcare Administration, or related field, or equivalent work experience required
Skills and Abilities
Intermediate level MS Office skills & strong verbal and written Communication skills
10% ~ 15% work-related travel
Detailed-oriented with strong analytical and organizational skills

If you or anyone you know is interested, qualified and immediately available please answer the below questions and send an updated resume to us for immediate review and consideration.

Questions to answer when you apply:1) How many years of experience of contracting with health care providers/managed care vendors
2) Do you have at least a bachelor's degree?
3) Are you fully Covid vaccinated?
4)Do you have Working knowledge and experience in health insurance, managed healthcare and medical claims processing?
5) What is your desired yearly compensation?
6) Is Aurora, IL a good location for you working in a hybrid position?
(This job listing is assigned to be sent to:

Chris .)

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