Senior Managed Care Specialist( Provider Enrollment )

Job Responsibilities

• Independently execute and manage managed care tasks within own area of responsibility (e.g., provider enrollment and credentialing, claims, payor issues).
• Work closely with internal and external teams (e.g., clients, customers) to coordinate, clarify information, and resolve issues.
• Support payer communications efforts (e.g., new publications, guidelines) and other supportive documentation.
• Manage denial issues related to contractual, enrollment or credentialing issues in a timely manner; monitor own delivery for compliance with overall guidelines, policies & procedures.

Requirements

• Minimum of 2 days/week onsite
• Minimum Requirement: 4+ years of experience in a healthcare, academic or research setting.
• Experience in healthcare office environment with some understanding of managed care contract and reimbursement models.
• Proven performance in earlier role.
• Experience with EPIC and CREDENTIALSTREAM preferred.

Qualifications

• High school diploma/GED required.

Skills

• Excellent communication skills.
• Strong problem-solving abilities.
• Ability to work independently and as part of a team.

Benefits

Explore our exceptional benefits!

Pay

In recognition of certain U.S. state and municipal pay transparency laws, St. Jude is including a reasonable estimate of the compensation range for this role. This is an estimate offered in good faith and a specific salary offer takes into account factors that are considered in making compensation decisions including but not limited to skill sets, experience and training, licensure and certifications, and other business and organizational needs. It is not typical for an individual to be hired at or near the top of the salary range and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current salary range is $29.00 - $50.50 per hour for the role of Senior Managed Care Specialist( Provider Enrollment ).

Schedule

Maintains regular and predictable attendance.