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Vivo Infusion® · 4 hours ago

Managed Care & Payer Relations Contracting Specialist

United States

Full-time

Remote

Mid Level

$25/hr - $30/hr

3+ years exp

Vivo Infusion is seeking a detail-oriented and collaborative Managed Care and Payer Relations Contracting Specialist to join their team. In this role, you will leverage your expertise in managed care to manage, track, and escalate payer issues efficiently, oversee payer contract management, and assist in the diligence process for potential acquisitions.

Health CareHospitalTherapeuticsWellness

Responsibilities

Manage, track and escalate payer issues in a timely fashion from OON notifications, benefits issues, single case agreement requests, extended claim denials, etc

Assist in the diligence process of potential acquisitions – gather, compile and record documents from W9’s, CLIA’s, state licensure, PTAN, Medicaid Numbers, enrollment documents, provider information / rosters and demographic location grids etc

Update location grid / rosters and send information updates to all contracted payers, informing them of demographic changes and additions

Create, compile and maintain payer applications for purposes of OON to PAR contract requests

Serve as the liaison during the de novo growth process to ensure all locations are entered and contracted with existing and future payers

Work with the contracting team to ensure communication of new and existing payer updates changes are communicated to teams internally in a timely fashion from operations, finance, legal, compliance, revenue cycle, credentialing, business development, etc

Reach out to payers to gather contracts and fee schedules in a timely manner including both existing and new agreements

Ensure all fee schedules and payer documents are up to date, tracking and maintaining on a quarterly basis, and communicating updates to the Finance team

Ensure successful tracking and dissemination of any payer policy, procedure, billing, claim, etc. updates as received from the health plans

Qualification

Managed Care ExperiencePayer Contracts UnderstandingDocument ManagementCommunication SkillsComputer LiteracyTyping SkillsOrganizational Skills

Required

3 years experience in managed care or similar role with transferable skills

Thorough understanding of payer contracts and the application process

High School Diploma or equivalent, required

2 years of Managed Care Contracting or a closely related experience

Experience working with large payer or provider organizations across multiple states, required

Ability to work in a matrixed environment and manage competing tasks and assignment

Ability to adjust attention and prioritize tasks based on the immediate needs of the department

Intermediate typing skills (50+ wpm), computer literacy with MS Office (Excel, Word, PowerPoint), and proficiency in learning new information systems

Benefits

Medical, Dental, Life, Vision + Option for HSA w/ Employer Contribution

401K with Match up to 4%

PTO: Accrual 4+ weeks/YR, buy-back program (get paid for unused PTO), and PTO donation program to allow Vivo team members to donate to others in need.

Wellness Reimbursement Program - $360 Annually

Employee Referral Bonus - Uncapped bonus potential

Tuition Assistance Program

Employee Assistance Program (Employer-provided)

Short & long-term disability (Employer-provided)

& More

Company

Vivo Infusion®

Vivo Infusion® is a leading provider of accessible, affordable, and safe community-based infusion and injection care for patients suffering from compromised immune systems, infectious diseases, and other medical conditions.

Founded in 2022

Lakewood, Colorado, USA

501-1000 employees