Consultant, Managed Care Policy, Baptist Health

Baptist Health System, Inc. • Akron, OH

5d • Remote

About The Position

Baptist Health is recognized as a top place to work in health care and is the leading provider in Northeast Florida, serving the community for over 30 years. As Jacksonville's only locally governed, faith-based, not-for-profit health system, Baptist Health offers a comprehensive range of services through more than 200 locations and six hospitals, including specialized centers for cancer, heart, neurology, and children's care. The Managed Care team is seeking a Managed Care Policy Consultant for a fully remote position, based in Jacksonville, Florida. Approved work states include Alabama, Florida, Georgia, Idaho, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, Ohio, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Virginia, West Virginia, and Wyoming. Baptist Health is committed to caring for the community across generations, focusing on innovative healthcare, improving health equity, and fostering a welcoming and inclusive workplace.

Requirements

• 7+ years experience in Legal, Revenue Cycle and Managed Care required.
• Deep understanding of healthcare operations, contract law, and regulatory frameworks.
• Detail-oriented, self-directed, and capable of managing multiple complex projects simultaneously.

Nice To Haves

• Juris Doctor Preferred

Responsibilities

• Proactively identifies, analyzes and resolves payer contract, underpayments and policy discrepancies and initiates timely contract disputes to recover lost revenue.
• Investigate identified trends and payer issues to identify root causes and will develop solutions and communicate with internal and external contacts to resolve payer issues.
• Collaborate with internal departments, including Revenue Integrity, Billing, Patient Access, Operations and Finance to develop thorough responses to plans.
• Draft Notices and Formal Disputes to send to plans or government entities.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior