Managed Care Consultant

Job Description

Blue & Co., LLC is hiring a Managed Care Consultant to provide subject matter expertise and technical assistance on matters related to Managed Care contracts, modeling, and operational best practices. This person will work with Blue’s healthcare reimbursement and revenue cycle teams to serve healthcare providers with issues related to Managed Care.

Specific Duties:

Read and interpret managed care contract terms, payment logic, and hierarchies to determine opportunity areas of focus for healthcare providers.

Work with providers to articulate issues requiring attention, and develop processes and work plans to address identified issues.

Review, test, and analyze large utilization data sets from healthcare providers.

Oversee and prepare financial models utilizing various database software systems.

Development of exhibits and narrative reports outlining our analysis & reimbursement impacts.

Daily verbal and written communication with healthcare providers & health plans

Qualifications

Must have a minimum of three-five years of Managed Care related experience.

Strong background in healthcare reimbursement analysis, including an understanding of diagnosis and procedure coding, billing practices, and payment methodologies.

Understanding of contract language and managed care contract modeling.

Strong analytical skills; exceptional attention to detail and demonstrated ability to prioritize tasks to ensure accuracy and timely completion.

Investigational and analytical skills with a proven ability to communicate effectively in both written and verbal format with internal and external clients.

Strong organization and documentation skills.

Advanced skills in MS Excel, Word, and various database programs.

Must be able to lead and coordinate projects through various complex and challenging situations to completion under time-sensitive deadlines.

Ability to work autonomously, meet tight deadlines, and thrive in a fast-paced environment with shifting priorities.

Highly motivated, ambitious individual with a strong desire to contribute to our rapidly growing Healthcare Consulting team.

We are responsive. We are caring, We are advocates.

Blue & Co., LLC, ranked as a top 60 accounting firm in the U.S. by Accounting Today, has seen unprecedented growth since its inception in 1970. With 10 offices in three states (IN, KY, and OH) and over 400 professionals, Blue is proud to serve clients in the Construction, Manufacturing, Distribution, Healthcare, Agribusiness, Financial Services, and Not-for-Profit industries.

At Blue, we offer a unique work environment where you are truly appreciated, rewarded and recognized for your contributions. It's these very characteristics that led to our being named to the 2020 "Best Places to Work" in Indiana and Kentucky and a "Best Employer in Ohio".

Guidance, opportunity, flexibility and support -- that's life at Blue & Co., LLC.

Blue is an equal opportunity employer. M/F/D/V

Full-time