Managed Care Specialist (Finance)

Devereux Advanced Behavioral Health • Orlando, FL

12h • Onsite

About The Position

Devereux Florida is seeking a Managed Care Specialist to join their team. This role is responsible for managing various aspects of managed care, including submitting rosters, completing re-credentialing applications, credentialing new hires, managing system configurations, tracking contracts, coordinating audits, processing contracts and amendments, and organizing meetings with Managed Care agencies. The position is full-time, Monday-Friday, and is an in-person, on-site role.

Requirements

• Bachelor's degree in Finance, Business or related required OR In lieu of bachelor's degree: 5+ years experience in Contracts or Managed Care can substitute for education required
• Experience in managed care, credentialing, or healthcare administration preferred.
• Strong communication and organizational skills.
• Ability to work independently and manage multiple tasks.
• Familiarity with CAQH, Medicaid processes, and insurance credentialing preferred.
• Valid driver's license required
• Successfully pass pre-employment medical screenings which include: Drug Screen.
• Successfully pass a Level 2 background screening with the State of Florida.

Nice To Haves

• Familiarity with CAQH, Medicaid processes, and insurance credentialing

Responsibilities

• Submit monthly rosters to all Managed Medicaid agencies (new hires, changes, terminations)
• Complete re-credentialing applications for Florida Medicaid programs, Medical Doctors (MDs) and ARNPs
• Renew Florida Medicaid provider numbers
• Credential all new MD and ARNP hires with Managed Medicaid agencies
• Complete system configuration requests in myAvatar (guarantor rates)
• Manage contract tracking and related Excel spreadsheets
• Maintain spreadsheets for Managed Care, commercial insurance, and Medicaid
• Coordinate and manage Managed Care audits (including medical record submissions)
• Process contracts, amendments, funding letters, and single case agreements
• Organize and lead meetings with Managed Care agencies (contracting, credentialing, claims)

Benefits

• Up to 24 PTO days/year (increases with service)
• Up to 64 hours of sick time
• Low-cost medical, dental, vision
• Devereux Benefits
• 403(b) retirement plan
• ASCEND Tuition Program: 100% tuition covered (up to $15k undergrad / $25k grad per year)
• Student loan repayment assistance
• Payactiv: Access your earned wages early
• Employee Assistance Program & Discounts

What This Job Offers

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