Managed Care Negotiator I

BayCare is currently in search of our newest Managed Care Negotiator I who is passionate about providing outstanding customer service to our community. BayCare’s top priority is the health and well-being of our communities as Tampa Bay's leading multi-specialty group with more than 600 providers practicing 45 specialties in over 175 outpatient locations throughout the Tampa Bay and west central Florida regions.

Position Details

• Location: Remote must reside in Florida
• Status: Full Time (non-exempt)
• Shift: 8:00 AM - 5:00 PM (may vary)

BayCare is all about making the most of your life and loving your career. BayCare provides an array of benefits to help you meet the daily challenges of balancing all aspects of your life and career goals.

• Benefits (Health, Dental, Vision)
• Paid time off
• Tuition reimbursement
• 401k match and additional yearly contribution
• Yearly performance appraisals and team award bonus
• Community discounts and more

AND the Chance to be part of an amazing team and a great place to work!

The Managed Care Negotiator I Is Responsible For

• Negotiates agreements under supervision from manager and/or director.
• Supports managed care negotiations by drafting contract language, preparing internal stakeholder presentations, and assisting with re-negotiations under guidance. Evaluates and leads small health plan entrant proposal reviews for inclusion in BayCare's network.
• Performs basic financial analysis to support rate proposals, collaborates with analysts to verify assumptions, and prepares counter proposals.
• Reviews physician credentialing agreements, identifies compliance issues, and assists in resolving disputes with payors.
• Communicates with payors and internal teams throughout negotiation, implementation, and operational phases, and maintains summaries of contract terms. Acts as primary point of contact for assigned payers and is responsible for leading internal and external meetings.
• Maintains current files on managed care companies, including contracts, matrices, and correspondence, and distributes notices of contract changes.
• Assists in developing educational materials and provides credentialing information to payors as needed.
• Under general supervision, evaluates and enforces contract compliance.
• Facilitates issue resolution with internal and external stakeholders.

Required

Education:

• Bachelor's Degree with 2 years of Healthcare or Insurance/Payor experience; OR
• 1-year of relevant experience with a Juris Doctorate

Experience

• Required : 1-year legal experience or 2 years of Managed Care, Healthcare, or Insurance/Payor experience

Equal Opportunity Employer Veterans/Disabled