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Managed Care Analyst

Ensign Services

This is a Full-time position in Tempe, AZ posted July 12, 2021.

About the Company
Ensign Services, Inc. (“ESI”) is a subsidiary of The Ensign Group, Inc. whose affiliated entities are considered national leaders in the fast growing post-acute care industry. ESI provides service and support to over 230 facilities in the long term care continuum that employ over 30,000 employees.

ESI is known as the “Service Center” and it provides the facilities and leaders it serves with necessary “back-office” support in areas such as accounting, construction, compliance, human resources, information technology, legal, risk management, and learning management. This structure allows on-site leaders and caregivers to focus squarely on day-to-day care and business issues in their individual operations.  What sets ESI apart from other companies is the quality of our most valuable resource – our people. We take our core values of Celebration, Accountability, Passion for Learning, Love One Another, Intelligent Risk Taking, Customer Second, and Ownership (CAPLICO) seriously and strive to provide a work experience that proves it!

About the Opportunity
The Managed Care Specialist Resource supports the Skilled Nursing Facility leaders and  partners with our Managed Care Resources in contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the healthcare industry.

Responsibilities:

  • Provide education and training for facility staff on LOAs’, Carve Outs and managed care contracts
  • Maintain and coordinate managed care contract amendments, notices and updates.
  • Provide training with facility personnel on admissions processes, case management utilization and enhancing revenue opportunities
  • Ownership of all contract summary updates for Arizona market
  • Project management of facility data requests
  • Assure facilities obtain viable hospice contracts in collaboration with legal department
  • Maintain facility personnel directory master to assure effective communication to the field
  • Own communication updates from health plan portals to the field

Desired Qualifications:

  • Experience in Skilled Nursing managed care advantage, managed Medicaid and Medicare plans
  • Minimum 2 years’ experience in skilled nursing or healthcare industry.
  • Experience in successful operationalizing managed care contracts in the skilled nursing environment.
  • Knowledge of contracts and contractual interpretations for payment and benefit issues.
  • Knowledge of medical terminology, claims payment and problem resolution; ability to work collaboratively in a team setting.
  • Working knowledge of Medicare guidelines for skilled care
  • Communicate effectively at all organizational levels and in situations requiring instructing, persuading and advising.
  • Comfortable leading in-person training in front of large groups.
  • Ability to manage confidential matters responsibly. Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
  • Strong analytical mind, with problem solving skills, an aptitude for accuracy, and attention to detail.
  • Must be able to prioritize, plan, and handle multiple tasks and demands simultaneously.
  • Excellent verbal and written communication skills, as well as excellent critical thinking skills.
  • Computer savvy (MS Word, MS Outlook, Excel, Smartsheet and Webex).
  • Ability to be flexible, be readily adaptable, and work in a rapidly and constantly changing environment.
  • Present to facilities on a monthly basis.
  • Willing to travel 30-40% of the time to local AZ facilities.

Additional Information:
**This full-time, exempt position will be based at the Service Center in Tempe, AZ.

We are committed to providing a competitive benefits and compensation package which includes medical/dental/vision coverage, company-provided life insurance, 401(k) with company match, and sick/vacation plans. Additionally, enjoy access to our fully equipped onsite gym (San Juan Capistrano office location).  We also believe in supporting our employee’s professional growth and development through our Learning Management System as well as training sessions and seminars. 

Ensign Services, Inc. is an Equal Opportunity Employer. Pre-employment criminal background screening required.

The employer for this position is stated in the job posting. Ensign Services, Inc. provides recruiting services for operations in the skilled nursing, assisted living, home health and hospice industries.

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