Oncology Consultants Jobs Page

Managed Care Contracting Liaison

Employment: Operations

Type: Full Time

Location: Houston, TX

"You can make a difference in the life of an oncology patient and find your career satisfaction by joining our team of healthcare professionals today."

About Oncology Consultants

Oncology Consultants has been a premier adult medical oncology & hematology practice in Houston, TX for over 35 years. Our healthcare team is committed to provide state of the art cancer treatment in a caring environment as we continue to expand our oncology services in the metropolitan region.

About the Position:  

This position is responsible for assisting in managing development and maintenance of harmonious working relationshipst with various payers and internal practice departments. This includes maintaining or improving payer composition and reimbursement arrangements, improving financial impact, and reaching company goals.

Shift Schedule:

  • Mon - Fri: 8am - 5pm

Benefits: Will be available upon becoming Full time

  • Insurances: Life, medical, dental, short term and long term disability
  • 401K
  • Free parking
  • PTO
  • Holidays 
  • Competitive salary 
  •  

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Learn and become proficient with Oncology Consultants Practice Management System which includes: a. Multiple reimbursement methodologies, payer fee schedules for Professional, Drugs, Radiology, Radiation and other medical services. Conduct contracting business under direct supervision of Director of Contracting & Development (CD).
  • Understanding multiple payer policies, and the ability to communicate educate and resolve payer issues with internal customers (staff). The ability to advocate for practice with Managed Care companies (multiple payers) to find solutions in gaining efficiency, receipt of payment, bridging a positive understanding and relationship with external customer (Payers).
  • Maintain Contracting Database, Contracting Knack (Internal requests/issues database log) in regard to payer inquiries with internal customers and payers’ problems. This includes maintaining all executed agreements and amendments in original paper and electronic files.  
  • Learn and collaborate with regarding new value-based programs, metrics. Understanding payment methodologies, reimbursement/collections, referrals, authorizations, and payers’ policies among major payers, in the Houston area. Including IPAs, and ACOs models.
  • Responsible for maintaining a professional relationship with payers. Ensure effective liaison and rapport is developed and maintained through meetings, correspondence and telephone calls.
  • Experience with multiple major payer policies, procedures, payment methods, benefits structures, referral, authorizations, billing and collections workflow. .  
  • Works with internal department regarding payer fee schedules methodology, new drugs and codes and corrections deemed necessary. Facilitates payer analysis on payer trends or inaccurate payment reimbursement based on contractual agreement.
  • Coordinate with provider onboarding regarding payer credentialing and quality assurance programs.
  •  Attend Contracting meetings as required.
  • Work closely with payers to assume payer websites and directories are correct on geographical practice profile.
  • Organize Contracting Departments annual major payer meetings.  Assure staff is kept informed of pertinent changes in payer policies and procedures.  Ensure appropriate education/in-servicing is made available to staff. Education may pertain to managed care and areas where pertinent rulings/regulations could affect business.
  • Ability to multitask in a timely manner, in a medium size growing group practices and ensure our customer services requirements and needs are always met by “Doing It Right the First Time.”
  • Strong Communication skills, team collaborative, interdepartmental transparency, and interact effectively and professionally with co-workers, management, patients, payers etc.     
  • Comply with HIPAA, Company Integrity, Compliance Program policies and other applicable company and departmental policies.
  • Maintain complete confidentiality of company business.
  • Maintain communication with Director of Contracting and management regarding development within areas of assigned responsibilities and perform special projects as required or requested.

JOB REQUIREMENTS:

  • Bachelor’s degree with 2 years’ experience or college courses in Health Care Administration or ten years of experience in the Healthcare industry in insurance plan benefits, referral, authorization, reimbursement, front office, and important ability to navigate in a multiple payer environment.  
  • Proficient with Microsoft Excel; analytical skills, experience or ability to learn excel  Pivot Tables, VLOOKUPS, Payment Management System and other software tools.
  • PC skills to include Microsoft, Word and PowerPoint.
  • Verbal and written communication skills to interact with all levels of health plan’s personnel.
  • Analytical abilities, planning skills and organization skills.
  • Experience meeting deadlines with multiple simultaneous projects and work well under pressure.
  • Team player/people oriented.

PREFERRED JOB REQUIREMENTS:

Analyze, report, managed data and database to support contracting strategies

LANGUAGE SKILLS:

  • Proficient in written and verbal English
  • Bilingual is a plus

COMMENTS: This description is intended to describe the essential job functions, the general supplemental functions and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities and requirements of a person so classified. Other functions may be assigned, and management retains the right to add or change the duties at any time. 

Oncology Consultants is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Medical Center | Memorial City | Sugar Land | Katy | Willowbrook | Southwest Northwest | West Houston

Apply today. Our short application process takes less than 5 minutes with your phone, tablet or computer.