Managed Care Specialist (Finance)

Devereux•Orlando, FL

4d•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 contracts and credentialing for mental and behavioral health services. The ideal candidate will be detail-oriented and possess strong organizational and communication skills. Devereux is a large nonprofit organization dedicated to providing exceptional behavioral healthcare services to children, adolescents, and adults.

Requirements

Bachelor's degree in Finance, Business or related required OR 5+ years experience in Contracts or Managed Care can substitute for education
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)