- Time Management
- Microsoft Word
- Word Processing
- Data Entry
- Communication Skills
Reports to the Executive Director. Responsible for assisting the Managed Care Executive Team in negotiating, maintenance, problem resolution and internal coordination of assigned managed care contracts and proposals for Beacon Health System. Works with the Managed Care Executive team to manage the contract process for Beacon Health System. Acts as a service representative for internal clients and payors, scheduling in-services as needed and works to provide information to Beacon Entities to enable them to operationalize their managed care agreements. Responsible for maintaining contracting files. Supports the management team by providing input into the strategic planning process. Responsible to assist with the Beacon ACO as directed.
MISSION & VISION
Mission: To enhance the physical, mental and emotional well-being of the communities we serve as the community’s provider of outstanding quality, superior value and comprehensive health care services.
Vision: Our vision is to achieve:
Innovative health care and well-being services of the highest quality at the greatest value
Easy access and convenience
Outstanding patient experiences
Ongoing education involving physicians, patients and the community
Education and Experience
The knowledge, skills and abilities as indicated below are normally acquired through the successful completion of a Bachelor's Degree in Business, Economics, Marketing or a related field. A minimum of three years of managed care and group insurance experience, through which a background in Medicaid, Medicare and physician contracting was gained, is required.
Knowledge & Skills
Requires an in-depth knowledge and understanding of employee benefit products/plans, including health/medical, dental and workers compensation, case processing (proposal, renewal, plan design, billing, claims, etc.) and the regulatory provisions of the Health Insurance Portability & Accountability Act of 1996 (HIPAA).
Requires well-developed knowledge and understanding of PHO, HMO, PPO and POS healthcare delivery systems.
Demonstrates proficiency in basic computer skills (i.e. data entry, word processing, spreadsheets and database applications).
Requires strong skills in organization, time management, research and analysis.
Requires an in-depth understanding of contractual language, computer systems, accounting and finance.
Demonstrates well-developed communication skills necessary to effectively communicate both verbally and in writing and to make presentations to individuals and small and large groups.
Demonstrates a high level of interpersonal skills in order to ensure that effective relationships are developed, maintained and managed in a professional and effective manner with medical staff members, Hospital and System management team, patients, representatives of client organizations, business leaders, various public managers, physician groups and legal counsel.
Works in an office environment.
May be required to vary hours and days, and work on holidays, etc., depending upon the needs of the department.
Requires the physical ability and stamina to perform the essential functions of the position.
Location: Beacon Health System · Business Intelligence
Schedule: Full-time, Day, 8:00am - 5:00pm; Monday - Friday