Managed Care Senior Specialist

  • Carolinas Healthcare System
  • Charlotte, NC, USA
  • Apr 25, 2018
Full time Healthcare

Job Description

Location Details: 
Carolinas HealthCare System is Atrium Health. Our mission remains the same: to improve health, elevate hope and advance healing - for all. The name Atrium Health allows us to grow beyond our current walls and geographical borders to impact as many lives as possible and deliver solutions that help communities thrive. For more information, please visit
Job Summary
Manages the day to day relationships between Carolinas Healthcare System (CHS) and Managed Care Organizations (MCOs) within portfolio.

Essential Functions
  • Supports leadership on assigned payor negotiations, including assistance with financial and operational evaluations, creating documents for review, and language review.
  • Develops and maintains team-focused and cooperative internal working relationships with all revenue cycle areas of CHS.
  • Manages administration of the assigned portion of the contract portfolio. Understands and interprets managed care contracts and reimbursement terms which impact the revenue cycle.
  • Creates and maintains electronic document database as well as original permanent files of all contract documents.
  • Communicates and educates teammates regarding operational implementation of new contract terms that affect revenue cycle functions.
  • Manages the implementation process for all new or re-negotiated managed care agreements.
  • Serves as operations account manager for assigned MCOs.
  • Serves as advisor and point of contact for all CHS revenue cycle personnel for trended managed care operational and administrative issues.
  • Understands scope of entire project, devises component tasks and assures they are completed.
Physical Requirements
Performs most work under normal office conditions which may include sitting for long periods of time, standing, walking, using repetitive wrist and arm motion or lifting articles up to twenty-five pounds. Requires frequent verbal and written communications in English to payors, teammates, corporate team, physicians, and others throughout CHS.

Education, Experience and Certifications
Bachelors Degree or equivalent experience required; Five years total experience in negotiations or contract administration with payer or provider; or ten years provider PFS experience.

At Carolinas HealthCare System, our patients, communities and teammates are at the center of everything we do. Our commitment to diversity and inclusion allows us to deliver care that is superior in quality and compassion across our network of more than 900 care locations.
As a leading, innovative health system, we promote an environment where differences are valued and integrated into our workforce. Our culture of inclusion and cultural competence allows us to achieve our goals and deliver the best possible experience to patients and the communities we serve.
Posting Notes: Not Applicable
Carolinas HealthCare System is an EOE/AA Employer