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Horizon Blue Cross Blue Shield of New Jersey

Hopewell, New Jersey

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Blue Cross and Blue Shield of Alabama

Hoover, Alabama

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Manager of Managed Care Contract & Operations
JOB SUMMARYThis position is responsible for providing operational support on managed care contracts as assigned by Vice President or System Director. The incumbent will be responsible for working directly with managed care payors and Revenue Cycle Operations (RCO) to resolve claim payment and administrative issues occurring with managed care contracts. The incumbent will work collaboratively with Vice President Managed Care, Managed Care Team, Revenue Integrity, and RCO management.ESSENTIAL FUNCTIONS OF THE ROLEInvestigates and resolves reimbursement issues, with the focus being root causes, identified by BSW or payors. Carries out appropriate managed care related education and training including roll out of new payor contracts.Assist


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