Managed Care Contract Operations Manager - Remote

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Requirements:

• Bachelor's degree in business, healthcare administration, computer science or related field, or equivalent experience.
• Three years of previous experience in healthcare, preferably with claims administration, either provider or health plan.
• In lieu of degree, five years of experience in managed care or healthcare operations, preferably with claims administration.
• Knowledge of managed care authorization, claims, and denials processes.

Responsibilities:

• Responsible for payor contract claims processing and payment terms across the Ministry.
• Ensure compliance with contract terms and optimize contract performance.
• Maintain relationships with managed care organizations.
• Coordinate claims escalations and settlement processes.
• Bring resolutions to escalated claims and settlement issues.