Managed Care Contract Specialist

Join Evanston Northwestern Healthcare, the only healthcare system to be named a Top 100 U.S. Hospital for 11 years by Solucient ®.

We are currently seeking a Managed Care Contract Specialist for our Business Office.  This position is located in Skokie.

 In this role, you will:Analyze current and proposed agreements between ENH and Managed Care payorsSupport and/or partner with Director in contract negotiations; occasionally lead negotiationsDevelop and maintain contract resources in order to support Contract AdministrationSupport departmental objective for data self sufficiency, meaning, extracting and compiling reports to be utilized by the DepartmentProvide clarification in regards to issues pertaining to Contract Administration and/or NegotiationsEstablish strong relationships with key contacts at payor organizationsIdentify underpaid BCBS claims by utilizing complex Accounting Systems and resolve claim these claims

 

 

Our ideal candidate will have:Associate’s Degree required; Bachelor’s Degree in Accounting or Business Management preferred2-3 years of business and/or healthcare experience requiredMust be familiar with managed care terms with ability to conduct contract modeling and analyze data related to contract modeling and contract underpaymentsStrong knowledge of CPT, ICD-9 procedure and diagnosis codes, DRGs and revenue codesStrong interpersonal and writing skills including the ability to communicate, in a clear concise manner via e-mailMust have excellent organizational skills and project management skillsUnderstanding of relationships between all relevant reports and the appropriate business functionsAbility to identify problems and recommend solutions through the design/modification of processes and proceduresStrong analytical skills and ability to summarize and understand large amounts of interrelated dataCommitment to integrity and confidentiality of financial information

 

 

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Evanston Northwestern Healthcare is a 3-hospital healthcare system located in the northern Chicago suburbs, along the shores of beautiful Lake Michigan.  Recently named a Most Wired Hospital**, our commitment to technology drives the way we practice medicine. 

 

We strongly believe that our reputation as a premier healthcare system depends upon those who invest their careers with us.  For our mission--to preserve and improve human life-- a work environment that retains happy, satisfied employees is essential. 

 

As part of our organization, you’ll find competitive salaries, comprehensive benefits, 2 retirement plans (a 403B & an employer-funded pension) & a generous vacation package.  Our tuition reimbursement program & extensive training curriculum make it an ideal place for continued learning.  

To find out more about life at ENH or to apply for this position, please visist our Careers Web site at www.enh.org/careers.

AA/EOE

 

**Hospitals & Health Networks