Job ID: AC-1032036 Description:
BASIC FUNCTION: This position is responsible for reviewing non-standard contracts for system capacity, implementing and auditing contract completion, handling contract inquiries by conducting research and coordination through various departments in resolution and responding to inquiries, conducting contract analysis and modeling, conducting quality control and analysis of quality reporting, preparing quality improvement recommendations, preparing documentation and training materials, and as the senior responsible to train/mentor staff, distribute work, handle escalated issues, handle special projects, assist manager, and provide performance information to manager.
JOB REQUIREMENTS: *Four years experience working in a managed care/ healthcare environment. *2 years provider contracting implementation and auditing experience.
*Health care management database experience. Experience in one or more of the following systems; Access, Blue Chip, Vistar, Terminal Emulator, Premier Pricing, and/or Premier Provider.
*Knowledge of managed care products.
*Knowledge of provider contracting.
*Knowledge of CPT, HCPCS, ICD9, Revenue code and/or DRG coding practices.
*Project management experience.
*Technical documentation skills.
*Leadership skills to train/mentor staff, distribute work, and handle escalated issues.
*Flexibility to meet deadlines in an environment of constantly changing priorities and workloads.
*Analytical skills including modeling.
*Verbal and written communications skills including interpersonal skills to work across the organization to resolve problems, responding to inquiries, compose procedure manuals and training materials, and to discuss business and technical aspects with all levels of management.
*Knowledge with both mainframe and windows based applications. *PC skills including Microsoft Office with proficiency in Excel.
PREFERRED JOB REQUIREMENTS: *Bachelor degree
HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace.
Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Expertise Other Job Type Full-Time Regular Location TX - Richardson