Consultant, Managed Care Policy, Baptist Health

About Baptist Health 
Recognized as a top place to work in health care, Baptist Health cares for more patients in Northeast Florida than any other provider, ranking as “most preferred” for more than 30 years. We’re Jacksonville's only locally governed, faith-based, not-for-profit health system and provide a full spectrum of preventive and specialty care through 200+ locations and six hospitals. Our centers of excellence include Baptist MD Anderson Cancer Center, Baptist Heart Hospital, Baptist Neurological Institute and Wolfson Children's Hospital. 

Baptist Health is hiring a Managed Care Policy Consultant for our Managed Care team! This is a fully remote opportunity located in Jacksonville, Florida.   

Approved work states:  Alabama, Florida, Georgia, Idaho, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, Ohio, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Virginia, West Virginia and Wyoming

Managed Care Policy Consultant, Job Responsibilities:

• Proactively identifies, analyzes and resolves payer contract, underpayments and policy discrepancies and initiates timely contract disputes to recover lost revenue.
• Investigate identified trends and payer issues to identify root causes and will develop solutions and communicate with internal and external contacts to resolve payer issues.
• Collaborate with internal departments, including Revenue Integrity, Billing, Patient Access, Operations and Finance to develop thorough responses to plans.
• Draft Notices and Formal Disputes to send to plans or government entities.
• Have a deep understanding of healthcare operations, contract law, and regulatory frameworks, and is detail-oriented, self-directed, and capable of managing multiple complex projects simultaneously.

Experience Requirements:

• 7+ years experience in Legal, Revenue Cycle and Managed Care required. 

Education & Credential Requirements:

• Bachelor’s Degree
• Juris Doctor Preferred

If you are interested in this Managed Care Policy Consultant position at Baptist Health, please apply today!

Primary Location:

Metro Square