Chestnut Health Systems

Managed Care Supervisor

Location US-IL-Bloomington
Job ID
2018-1868
# Positions
1
Type
Regular Full-Time
Category
Administration

Overview

Chestnut Health Systems is a leading provider of behavioral and primary health care services. Over four decades, Chestnut has grown to over 700 committed, compassionate employees providing substance use, mental health and primary care treatment to patients in Central and Southern Illinois. We provide fully integrated care for all of our patients by combining behavioral health care services with our community-based primary care health centers. Chestnut also conducts research and training throughout the U.S.A.

 

Chestnut Health Systems is seeking a knowledgeable, full-time Managed Care Supervisor to work at our Bloomington, IL facility.

Responsibilities

  • Manage the contracting process for insurance contracts including procuring applications, leading all communications related to negotiating, finalizing and maintaining contracts.
  • Manage all aspects of credentialing of clinical staff and prescribers including assisting in opening individual staff profiles in CAQH and ensuring all staff profiles are up to date.
  • Ensure all eligible clinical staff and prescribers are on all insurance contracts/panels by managing all aspects of the process.
  • Assist with identifying facility and provider network needs.

Qualifications

  • Position requires a bachelor’s degree in a health care or business related field with a minimum of three (3) years’ experience in a health care setting (behavioral health preferred).
  • Or an equivalent combination of relevant education and working experience.
  • Must have an understanding of Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes, along with various types of insurance plans (e.g. managed care, ICP, MMAI, commercial, and government).
  • Must have an understanding of various systems, including IMPACT, PECOS, NPPES and CAQH.
  • Must be able to effectively problem solve, as well as have a strong attention to detail, organization, communication (written and verbal) and follow-up skills.
  • Prioritization and effective time management skills are a must.
  • Must have the ability to work independently with minimal supervision; the ability to handle confidential material; and the ability to plan and organize.
  • Computer experience including knowledge of Microsoft Office including Word and Excel, along with other products required.
  • Satisfactory completion of Chestnut’s background checking process.

This full-time position includes an excellent compensation and benefits package including health, dental, life, and disability insurance, a retirement savings plan with company match, generous paid time off benefits, and more.     

 

For immediate consideration, please see us at www.chestnut.org/employment

 

Chestnut welcomes applications from qualified individuals with recovery experience.

 

EOE – Minorities/Females/Vets/Disabled

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