Managed Care Specialist (Finance)

Devereux•Orlando, FL

3d•Onsite

About The Position

Devereux Florida is seeking a Managed Care Specialist to join their team. This role is responsible for managing contracts and managed care relationships, 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. Devereux provides mental and behavioral health services as well as child welfare case management services.

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.

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
Student loan repayment assistance
Payactiv: Access your earned wages early
Employee Assistance Program & Discounts
Medical (including telemedicine via phone, web, app), dental, prescription drug, preventative care, and mental health services.
Student loan debt assistance, tuition reimbursement and continuing education assistance.
Generous time-off (start accruing 1st day), 403(b) retirement plan with matching benefit, and voluntary/employee paid supplemental life and accident coverage.
Employee assistance / work-life balance program.