Managed Care Strategist

Total Rewards

"Your life - our Mission"

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Expected pay for this position is $38.75 - $45.59/hour. Actual pay will be determined by experience, skills and internal equity. This is a Salaried position.

Overview

POSITION SUMMARY: The Managed Care Strategist is responsible for development of terms and negotiating OSF HealthCare’s managed care agreements and operational performance of payer relationships. The role collaborates with all OSF leadership across hospitals, physician practices, and ancillary entities to ensure effective contract implementation, address operational issues, and resolve payer related challenges. Serves to support OSF leadership with assessment of regulatory implications, performing gap analysis and developing detailed project work plans.

#Remote role open to: AR, FL, GA, ID, IL, IN, IA, KS, LA, MI, MO, NE, SD, TN, TX, WV, WI

Qualifications

REQUIRED QUALIFICATIONS:

Education: Bachelor’s degree in business or healthcare

Experience: Five years’ related work experience in managed care contracting.

Other Skills/ Knowledge:

• Excellent interpersonal and communication skills.
• Solid computer skills, including proficiency with Microsoft software.
• Strong analytical and problem-solving skills, with the ability to be detail oriented.
• Working knowledge of state and federal managed care regulations, managed care processes, and healthcare delivery system operations.
• Understanding of Hospital and Professional Coding and reimbursement (Rev Codes, MSDRGs, CPT, HCPCS, etc.)
• Exceptional attention to detail, organizational skills, and ability to manage multiple priorities in a fast-paced environment.

PREFERRED QUALIFICATIONS:

Experience:

• Prior experience in a multi-hospital system, physician enterprise, or integrated delivery network.
• Experience with healthcare reimbursement methodologies, including risk based arrangements, value-based payment models, bundled payments, and quality incentive programs.

Licensure/ Certification: HFMA Certified Specialist Payment & Reimbursement (CSPR) and/or Certified Revenue Cycle Representative (CRCR)

OSF HealthCare is an Equal Opportunity Employer.