RN Clinic Case Manager (oumedicine)

Job Description

Position Title:

Department:

Job Description:

General Description: Reporting to the Director, Managed Care Contracting, the Managed Care Contract Coordinator assist the Director, Managed Care Contracting to organize, catalogue, store and archive all managed care agreements on behalf of OU Health hospitals and physicians.  This includes all payer agreements, Letters of Agreement (LOAs), single case agreements (SCAs), amendments and claims settlement agreements.  The Managed Care Contract Coordinator also performs facility/provider credentialing and payer enrollment as directed.

Essential Responsibilities:

Responsibilities listed in this section are core to the position.  Inability to perform these responsibilities with or without an accommodation may result in disqualification from the position. 

• Basic knowledge of payor contracting and managed are agreements
• Working knowledge of privileging, credentialing, provider enrollment and managed care contracting requirements, practices, and industry standards.
• Ability to be a liaison between Managed Care, Revenue Cycle and Operations.
• Strong attention to detail and well organized.
• Adapts well to rapid change and multiple, demanding priorities.
• Focuses on team success and promotes collaboration efforts with others.
• Excellent time and project management skills.
• Ability to network internally and externally to build relationships, facilitate discussion and resolution.
• Microsoft Office Suite advanced proficiency, particularly MS Excel, Access, and PowerPoint.
• Ability to make a significant contribution to the organization’s overall effectiveness.
• A mature approach to problem-solving for all types of issues

General Responsibilities:

• Performs other duties as assigned

Minimum Qualifications:

Education: High School Diploma or Equivalent required, Associate’s Degree preferred.

Experience: Two years of experience in managed care contracting or revenue cycle, Two years of experience in hospital, physician office or health insurance company

License(s)/Certification(s)/Registration(s) Required: none.

Knowledge, Skills, and Abilities: 

• Working knowledge of managed care contract interpretation and reimbursement methodology
• Ability to perform independently in a remote setting
• Must have excellent communication and customer relations skills

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OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family.