3-5 years of experience
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Employment Type:
Full time
Job Category:
Health Care Provider
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Carilion Clinic | Roanoke, Virginia
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Job Description

Support Carillion's hallmarks of service excellence and quality for all job responsibilities.

Assists with research, negotiation, development, and maintenance of managed care contracts.  Strategic activities include extraction and evaluation of data, creation of reports and submission of recommendations for improvements related to: contract formulation, negotiations with payers, performance monitoring, billing and collections and legal compliance.

In conjunction with senior staff, responsible for performing application system analysis and design specifically for contract implementation and contract compliance.  Includes knowledge of application requirements, specifications, configurations, documentation requirements, and the testing and implementation of applicable applications.  Will be required to make timely, effective decisions using independent judgment and discretion within the appropriate guidelines defined by leadership.

Minimum Qualifications Required

Education:  BS in computer, healthcare or business related field or 6 years equivalent work experience required.

Experience: 2 years of related experience required demonstrating:

Analytical and problem solving skills

Clear, effective communication skills

Detail orientation

Proficiency in PC

Licensure, certification, and/or registration:  EPIC proficiency; MPV access to basic and contract modules required.  Required upon acceptance of position or to be completed within 6 months of position placement.  CPC desired, but not required.

Other Minimum Qualifications: Working knowledge of managed care contractual terms and requirements, health insurance practices, industry regulator requirements, business office operations, patient registration, billing and accounts receivable functions, financial reporting technology and industry standards for healthcare revenue resolution management practices.

Must be a self-initiated team player with strong organizational and analytical skills. Must be able to work both independently and in a team setting.  Must be capable of prioritizing multiple projects and meeting deadlines. Effective oral and written communication, presentation and problem solving skills required.

Inspiring Better Health at Carilion Clinic

Every day at Carilion Clinic, our employees come together to inspire better health in our patients, their families and our communities. Explore how you can be a part of this diverse, innovative and interdisciplinary patient-centered team, and find out how you can make a difference in the lives of others.

As an employee, you can take advantage of our competitive pay, various scheduling options, continuing education opportunities and excellent benefits.

Based in Roanoke, Va., Carilion Clinic includes multi-specialty physician practices, seven not-for-profit hospitals and the Virginia Tech Carilion School of Medicine and Research Institute in partnership with Virginia Tech.

Service Excellence and Quality are hallmarks of Carilion Clinic. As a team member, you will be expected to consistently deliver the best in care and customer service. As an employee, you will demonstrate respect, dignity, kindness and empathy in each encounter with our patients, families, visitors and with each other.

Equal Opportunity Employer

Carilion is a Drug-Free Workplace

Minorities/Females/Protected Veterans/Individuals with Disabilities/Sexual Orientation/Gender Identity.


About Carilion Clinic

Carilion Health System is a $1 billion healthcare company serving approximately 1 million people in Western Virginia. Carilion is a comprehensive, integrated system employing nearly 10,000 people at 10 not-for-profit hospitals, 61 physician practices and primary care centers and a managed care division. As part of its mission to improve the health of the communities it serves, Carilion operates the region's only level 1 trauma center, air ambulance and neo-natal intensive care program, along with a full service cancer center and regional heart center.

This company profile was created by AfterCollege and is about Carilion Clinic. This page is not endorsed by or affiliated with Carilion Clinic. For questions regarding company profiles, please email: care@aftercollege.com.