Transplant Contract Specialist Managed Care

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family:

• Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
• Paid Time Off from Day One
• 403-B Retirement Plan
• 4 Weeks 100% Paid Parental Leave
• Career Development
• Whole Person Well-being Resources
• Mental Health Resources and Support
• Pet Benefits

Full time

Shift

Day (United States of America)

Address

2600 LUCIEN WAY

City

MAITLAND

State

Florida

Postal Code

32751

Job Description

• Participates in negotiation planning and development projects to support strategic alignment with contracted health plans.
• Seeks resolution to managed care issues by collecting and interpreting contract performance information to preserve the integrity of those contracts.
• Supports the timely start of contract negotiation activities by compiling information through research and coordination with departmental leaders.
• Maintains and negotiates contracts with external community provider groups to provide transplant services under AdventHealth global transplant contracts.
• Maintains Global Spreadsheet, capturing Solid Organ and Bone Marrow Transplant information.
• Corresponds with payer survey contact as needed and ensures any additional information requested by payer is provided in a timely manner.
• Assists with appeals and disputes of outcomes then reviews and forwards the decisions of these outcomes.
• Assists with resolving payment issues during the global billing period and ensures payments are made appropriately.
• Other duties as assigned.

• Typing:35 wpm [Required]
• Spreadsheet experience [Required]
• Email and computer calendar experience [Required]
• Detail oriented [Required]
• Assertive [Required]
• Read and understand contracts effectively [Required]
• Ability to problem solve and think analytically [Required]
• Strong organizational skills [Required]
• Effectively communicate with all department levels [Required]
• Ability to grow strong relationships [Required]

• Hybrid- Monday, Wednesday, Thursday onsite) Maitland, FL
• Full Time M-F 8am-5pm

• Bachelor's [Preferred]

• in Business or Healthcare Administration or related field

• 4+ years of experience in managed care or healthcare provider relations experience [Required]
• 5+ years in healthcare or insurance [Preferred]
• Experience in managed care contract negotiations for hospital, transplant and global services [Required]
• Healthcare billing experience [Preferred]
• Managed Care contract experience [Preferred]

• N/A

• N/A

Physical Requirements - https://tinyurl.com/23km2677

Pay Range

$49,718.59 - $92,468.74

Background Screening Requirement (Florida Law)

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse:

https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.