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Managed Care Specialist
cleoconsulting
Nashville, TN, USA
Negotiable
As a Managed Care Specialist, you will play a crucial role in the healthcare sector, focusing on the coordination and management of patients' care within health insurance frameworks. This position will be based in the vibrant city of Nashville, TN, and is offered as a contract role. Our company prides itself on providing efficient healthcare solutions and is committed to enhancing patient experiences and outcomes. In this pivotal role, you will interact with various stakeholders in the healthcare system, making a tangible impact on patients’ well-being and overall healthcare delivery.Key ResponsibilitiesConduct comprehensive legal research to ensure compliance with managed care regulations.Create and maintain thorough documentation regarding patient cases and insurance policies.Provide exceptional customer service by responding to inquiries and resolving issues related to patient care and benefits.Communicate effectively with healthcare providers, patients, and insurance companies to facilitate care management.Utilize critical thinking to evaluate patient needs and insurance coverage, recommending appropriate solutions.Manage time effectively by prioritizing tasks and adhering to deadlines in a fast-paced environment.Employ strong technical skills to navigate various healthcare software and tools efficiently.Required and Preferred QualificationsAssociate's Degree in Healthcare Administration, Business, or a related field.Proven experience in legal research, documentation, and customer service within the healthcare industry.Strong communication skills, both written and verbal.Excellent problem-solving abilities and critical thinking skills.Familiarity with healthcare regulations and managed care practices is preferred.Proficient in healthcare-related software and documentation tools.A minimum of 2 years of relevant work experience in managed care or a related field.In our collaborative team structure, you will work closely with other Managed Care Specialists, healthcare providers, and administrative staff, creating an environment that fosters teamwork and shared goals. You will report directly to the Managed Care Manager and collaborate with cross-functional departments including IT and compliance to ensure seamless operations.This role offers significant growth opportunities within the rapidly evolving healthcare landscape. Our company culture emphasizes collaboration, innovation, and adaptability. We provide modern workplace benefits, including flexible work hours, a supportive work environment, and access to professional development resources that encourage continual learning and career advancement.