Sr. Consultant, Managed Care - Remote

Overview

The Sr Consultant Managed Care serves as a key contributor supporting the organization's managed care strategy and contracting activities. This role partners with leadership and cross-functional teams to advance payor contracting efforts, manage policy review processes, and support agreement development.

In Short

• Support development, review, and negotiation of managed care agreements.
• Assist with drafting and maintaining network participation agreements.
• Serve as the primary Managed Care representative for payor policy review.
• Lead evaluation of policy updates and synthesize impacts.
• Negotiate varied and complex reimbursement methodologies.
• Collaborate with service line administration and Revenue Cycle.
• Prepare for complex payor negotiations.
• Monitor state and federal regulatory updates.
• Identify and implement process improvements.
• Gradually assume ownership of contract components.

Requirements

• Bachelor's degree in a related field required.
• 5 years of experience in managed care or healthcare contracting.
• Knowledge of payor policies and reimbursement methodologies.
• Strong analytical skills and ability to interpret complex data.
• Ability to manage multiple priorities in a fast-paced environment.
• Excellent written and verbal communication skills.
• Proficiency in Microsoft Office applications.
• Strong problem-solving skills.
• Ability to maintain confidentiality.
• Attention to detail and high level of organization.

Benefits

• Opportunity to work in a leading healthcare organization.
• Collaborative and innovative work environment.
• Competitive salary and benefits package.
• Professional growth and development opportunities.
• Commitment to diversity and equal opportunity.