Preferred Family Healthcare Managed Care Contract Specialist in St. Charles, Missouri
We're a Good Family to Know:
Preferred Family Healthcare (PFH) is a community-based healthcare organization that offers a full array of integrated services, serving more than 100,000 individuals each year in nearly 100 locations throughout Missouri, Oklahoma, Kansas and Illinois.
Our greatest reward has been the opportunity to serve families and communities in need for the past 40 years. At PFH, our future is brighter than ever! With changes in leadership, focused priorities and strong core values, PFH remains a “Good Family to Know!”
Your role at PFH:
As Managed Care Contract Specialist you will manage administration of the managed care contracts and the day-to-day relationships between the Preferred Family Healthcare (PFH) and Managed Care Organizations (MCOs), and coordinates the processes within Preferred Family Healthcare and MCOs that are necessary to secure new contracts, maintain the viability of existing contracts, maintain contracted rates within the chargemaster. You will:
Create and maintain electronic document database as well as original permanent files of all contract documents for all MCO contracts for PFH, and ensure that PFH has complete and fully executed copies of all active contracts.
Enter and maintain contract data in credentialing software.
Distribute all communication (ex. emails and newsletters) from MCOs to appropriate staff and leadership.
Review payor websites and external information, staying current with regard to changes to payor policies and other initiatives.
Monitor compliance with MCO contract terms and conditions and be a resource for PFH for managed care guidance and compliance.
Build and maintain relationships with all MCOs, keeping contact information current and available for credentialing and billing and scheduling meetings for the managed care and billing teams with MCOs as appropriate.
We think you'd be great for this role if you have:
Graduate of an Accredited College or University with a Bachelor's degree in Business, Finance or Health Care Administration; OR
Four (4) years experience working with a health care provider or payer in contracting or business operations.
You'll love being a part of our family because:
Our associates are our most valuable asset! We understand the role their satisfaction plays in the quality of services they provide. Through encouragement, our associates are empowered to optimize their strengths through ongoing training to ensure they are equipped and feel competent to serve our clients.
Our eligible associates enjoy some of the following PFH Perks:
Comprehensive medical, dental, vision, life insurance and disability plan options
Competitive 401(k) Retirement Savings Plan – up to 5% match!
Company paid basic life insurance
Paid Time Off Program for vacation, holiday and sick time
Emergency Medical Leave Program
Flexible Spending Accounts – healthcare and dependent child-care
Health & Wellness Program
Employee Assistance Program (EAP)
Employee Discount Program
Our human resources team wants to let you know what's required:
Employment is conditional upon the receipt of appropriate background checks. Upon offer of employment, you must grant permission for Preferred Family Healthcare to verify accuracy, legitimacy, and results in regards to the following conditions of employment:
Background check that includes criminal history and abuse/ neglect.
Motor vehicle driving record check.
Education and license/certification verification (if applicable).
Employment and/or personal reference checks.