Discover. Achieve. Succeed. #BeHere
Location: US:WI:MENOMONEE FALLS at our WOODLAND PRIME 400 facility.
This job is REMOTE.
FTE: 1.000000
Shift: 1st shift 8 am to 4:30pm CST (Cental Standard Time)
Job Summary:
The Managed Care Contract Coordinator (Account Rep, Account Manager, Contract Administrator, Contract Operations Rep, Network Rep) acts as a liaison with managed care organizations (e.g. insurance payers, networks, insurers) and with internal customers, (e.g., Patient Financial Services and clinical staff) to resolve issues related to managed care contract term requirements and contract reimbursement. Other duties as assigned.
The Managed Care Contract Coordinator manages the contracts with the insurance payers for the entire FH system. The position:
- Manages the relationship between the Insurance Payer and the Organization.
- Creates tools for the organization to use that references the contract terms and the contract reimbursement.
- Consults with clinical and business units to assess if contract terms are being followed.
- Identifies new contracting opportunities for strategic growth.
- Addresses operational issues and provides contract language to support appeals to the Payer and/or facilitates meetings with the appropriate parties.
- Ensure all documents associated with the negotiation/payer agreement are in the appropriate system accurately and performs audits on a regular basis to ensure accuracy.
Other duties as assigned
EXPERIENCE DESCRIPTION:
Three to five years of experience in a Health Care setting in either the payer or provider environment.
Demonstrated ability in resolving complex issues is required.
EDUCATION DESCRIPTION:
Bachelor's degree in Business, Finance, Accounting or related field is required. In lieu of degree will consider 7 years of health care experience.
SPECIAL SKILLS DESCRIPTION:
Knowledge of managed care principles and the insurance industry is required.
Ability to take initiative and exercise independent decision making.
Strong Communication Skills And Strong Organizational Skills Are Essential.
Project management experience and strong PC skills including database management, spreadsheets and SharePoint editor.
LICENSURE DESCRIPTION:
Managed care certification is preferred.
Perks & Benefits At Froedtert Health
Froedtert Health Offers a variety of perks & benefits to staff, depending on your role you may be eligible for the following:
- Paid time off
- Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities
- Academic Partnership with the Medical College of Wisconsin
- Referral bonuses
- Retirement plan - 403b
- Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics
- Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available
The Froedtert & the Medical College of Wisconsin regional health network is a partnership between Froedtert Health and the Medical College of Wisconsin supporting a shared mission of patient care, innovation, medical research and education. Our health network operates eastern Wisconsin's only academic medical center and adult Level I Trauma center engaged in thousands of clinical trials and studies. The Froedtert & MCW health network, which includes ten hospitals, nearly 2,000 physicians and more than 45 health centers and clinics draw patients from throughout the Midwest and the nation.
We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce. We welcome protected veterans to share their priority consideration status with us at 262-439-1961. We maintain a drug-free workplace and perform pre-employment substance abuse testing. During your application and interview process, if you have a need that requires an accommodation, please contact us at 262-439-1961. We will attempt to fulfill all reasonable accommodation requests. 
