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Managed Care Supervisor

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POST DATE 8/19/2016
END DATE 12/19/2016

KG Workforce Solutions Columbia, SC

Columbia, SC
AJE Ref #
Job Classification
Full Time
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KG Workforce Solutions is recruiting for a MANAGED CARE SUPERVISOR. The MANAGER CARE SUPERVISOR will assist the Director with day-to-day operations of Managed Care and related payment functions. The ideal candidate will have a strong educational and practical background in managed care within a provider organization and be familiar with mid-to-large size provider processes.

The MANAGED CARE SUPERVISOR will have responsibility for, but not limited to, the following:

* Assisting with personnel, budget, resource and reporting activities
* Overseeing payment compliance and assisting with contract management
* Facilitating dispute resolutions for payments and contracts
* Contributing to appropriate coding selection for reimbursement inquiries
* Supporting clinical entities within the organization on payment and managed care issues
* Monitoring managed care and reimbursements for reporting and compliance purposes


* Minimum of three years of experience in managed care operations within a provider organization of mid-to-large size (while payer-side experience may be beneficial, it cannot be substituted for provider experience)
* Knowledge of provider-based accounts receivable practices
* Familiarity with reimbursement processes
* BS/BA degree in healthcare administration, business administration or healthcare management
* Experience working with patient financial services and applications
* Experience with managed care contracts and contract negotiations
* Previous health plan provider research experience with in-depth knowledge of plan components

If this sounds like your background and you are looking to join a growing organization where your expertise can directly impact the effectiveness of managed care and payment activities, we encourage you to apply today.

This position requires onsite work in Columbia, SC. Remote work is not approved for this position. Visa sponsorship is not authorized for this position. No third party inquiries will be accepted.