Job Description
Full job description
VIVO Infusion, LLC
Managed Care and Payer Relations Contracting Specialist
Required qualifications for this position:
3 years experience in managed care or similar role with transferable skills.
Thorough understanding of payer contracts and the application process.
The Managed Care and Payer Relations Contracting Specialist will work remotely from a home office with a secure network. Only candidates residing in the states below at the time of employment will be considered. Travel with Vivo equipment is not permitted without prior approval.
Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, North Carolina, New Hampshire, New Jersey, Nevada, New York, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Wisconsin, Wyoming, Washington D.C.
Vivo Infusion Managed Care and Payer Relations Contracting Specialist:
VIVO Infusion is seeking a detail-oriented and collaborative Managed Care and Payer Relations Contracting Specialist to join our team. In this role, you will leverage your expertise in managed care to manage, track, and escalate payer issues efficiently, including out-of-network (OON) notifications, benefits issues, single-case agreement requests, and extended claim denials. You will be responsible for overseeing payer contract management, ensuring accurate and timely documentation, and managing the application process for new and existing contracts. You will also play a key role in the diligence process for potential acquisitions, gathering and compiling critical documents such as W9’s, state licensure, and provider information.
This role requires close collaboration with the contracting team, internal departments, and payers to ensure smooth communication regarding demographic changes, payer updates, and contract status.
The ideal candidate will possess strong organizational skills, an in-depth understanding of payer contracts, and the ability to effectively communicate and present ideas to a varied audience. If you're a motivated and results-driven professional with experience in managed care contracting, we invite you to apply for this exciting opportunity at VIVO Infusion!
Compensation:
Pay Range: $25.00 - $30.00 / hr
Bonus Plan Target: 5% Annually (Based on performance)
Private Equity for the Greater Good - Company-wide Employee Ownership Program
Benefits Offered:
Medical, Dental, Life, Vision
Option for HSA w/ Employer Contribution
401K with Match up to 4%
PTO: Accrual 4+ weeks/YR, buy-back program (get paid for unused PTO), and PTO donation program to allow Vivo team members to donate to others in need.
Wellness Reimbursement Program - $360 Annually
Employee Referral Bonus - Uncapped bonus potential
Tuition Assistance Program
Employee Assistance Program (Employer-provided)
Short & long-term disability (Employer-provided)
& More
Employment Type & Schedule, FLSA Status:
Full-Time
Monday - Friday, 8:00am - 5:00pm
Non-Exempt
Reports to: Director of Managed Care
Location: Remote
The Managed Care and Payer Relations Contracting Specialist will work remotely from a home office with a secure network. Only candidates residing in the states below at the time of employment will be considered. Travel with Vivo equipment is not permitted without prior approval.
Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, North Carolina, New Hampshire, New Jersey, Nevada, New York, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Wisconsin, Wyoming, Washington D.C.
Primary Role Responsibilities:
Manage, track and escalate payer issues in a timely fashion from OON notifications, benefits issues, single case agreement requests, extended claim denials, etc.
Assist in the diligence process of potential acquisitions – gather, compile and record documents from W9’s, CLIA’s, state licensure, PTAN, Medicaid Numbers, enrollment documents, provider information / rosters and demographic location grids etc.
Update location grid / rosters and send information updates to all contracted payers, informing them of demographic changes and additions.
Create, compile and maintain payer applications for purposes of OON to PAR contract requests.
Serve as the liaison during the de novo growth process to ensure all locations are entered and contracted with existing and future payers.
Work with the contracting team to ensure communication of new and existing payer updates changes are communicated to teams internally in a timely fashion from operations, finance, legal, compliance, revenue cycle, credentialing, business development, etc.
Reach out to payers to gather contracts and fee schedules in a timely manner including both existing and new agreements.
Ensure all fee schedules and payer documents are up to date, tracking and maintaining on a quarterly basis, and communicating updates to the Finance team.
Ensure successful tracking and dissemination of any payer policy, procedure, billing, claim, etc. updates as received from the health plans.
Qualifications:
High School Diploma or equivalent, required.
2 years of Managed Care Contracting or a closely related experience
Experience working with large payer or provider organizations across multiple states, required
Ability to work in a matrixed environment and manage competing tasks and assignment.
Ability to adjust attention and prioritize tasks based on the immediate needs of the department.
Intermediate typing skills (50+ wpm), computer literacy with MS Office (Excel, Word, PowerPoint), and proficiency in learning new information systems.
About Vivo Infusion:
The Vivo Infusion team is focused on providing patients with the highest quality of care in a comfortable, safe, and convenient setting! Vivo is a national company with locations in 15 states, providing opportunities for growth and advancement as well as competitive benefits that support what matters most to you.
Our highly trained medical professionals are dedicated to delivering a safe, comfortable, and affordable solution for our patients. We offer an array of advanced therapeutics and provide personalized, care for every patient.
We are passionate about providing high-quality patient care, relationships with our referring Providers, and nurturing our company culture!
Vivo Infusion has received The Gold Seal of Approval® from The Joint Commission.
The Joint Commission Gold Seal of Approval is a nationally recognized distinction voluntarily earned by a select set of healthcare providers.
An organization that achieves The Gold Seal of Approval® shows its commitment to holding itself accountable to a high bar for quality and safety for those they serve.
Learn more about Vivo, by visiting our website: https://vivoinfusion.com/
Work environment and physical demands:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. The physical demands described below are representative of those that must be met by an employee to successfully perform the essential functions of this job.
The employee must sit at a desk for most of their workday. The position also requires the employee to complete all tasks on the computer. These physical demands, while seemingly small, can place strain on the back, neck, wrists, hands, and eyes.
RECRUITMENT PRIVACY STATEMENT | Notice to All Applicants:
Vivo Infusion posts all open positions on the Careers page of the company website: https://vivoinfusion.com/careers/
Applicants will never be asked to provide personal identification information (e.g., SSN, Driver’s License, Passport) or financial information (e.g., Banking Information) during the application and Interviewing process.
We may request:
Contact details such as name, address, email address, and phone number.
Employment history including previous employers and job titles/positions.
Background information including academic/professional qualifications, job qualifications, education, certifications or licenses, details included in your CV/resume, transcripts, and employment references.
Nominated references including their name, contact details, employer, and job role.
Proof of your eligibility to work in the US.
Desired salary.
If you have any questions or concerns about this Recruitment Privacy Statement or how we handle your personal data, please contact us at 855.478.1528 or emailing Info@VivoInfusion.com.
