| Managed Care Specialist Job Description |
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| The following is a full job description for Managed Care Specialist. Here are the requirements and responsibilities for Managed Care Specialist along with statistics. If after reading this page you determine that Managed Care Specialist is not the position you are looking for, you may want to try one of these similar titles: Managed Care Supervisor, Managed Care Manager, Managed Care Pharmacy Consultant, SVP of Managed Care, SVP of Managed Care Pharmacy, Managed Care Director, Managed Care Pharmacy Director, VP of Managed Care Pharmacy, Managed Care Pharmacy Technician |
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| Requirements and Responsibilities For Managed Care Specialist |
| Responsible for reviewing and negotiating managed care contracts. Coordinates utilization reviews and evaluates financial impacts to support contract negotiations and maintain care quality. Identifies patterns in service use and recommends strategies to improve efficiency and reduce expenses. Tracks financial outcomes, stays current on policy updates, manages contract records, and prepares reporting. Ensures that patient care delivered to members meets quality standards and complies with applicable regulations. Requires a bachelor's degree. Typically reports to a manager. Occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. Typically requires 2-4 years of related experience. |
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| Also referred to as: Managed Care Contracting Analyst, Payer Relations Specialist |
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| Similar Jobs: Managed Care Supervisor, Managed Care Manager, Managed Care Pharmacy Consultant, SVP of Managed Care, SVP of Managed Care Pharmacy, Managed Care Director, Managed Care Pharmacy Director, VP of Managed Care Pharmacy, Managed Care Pharmacy Technician |
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| Level of Education: Managed Care Specialist Salaries with a High School Diploma or Technical Certificate, Managed Care Specialist Salaries with an Associate's Degree, Managed Care Specialist Salaries with a Bachelor's Degree, Managed Care Specialist Salaries with a Master's Degree or MBA, Managed Care Specialist Salaries with a JD, MD, PhD or Equivalent |
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| Industries: Edu., Gov't. & Nonprofit, Healthcare | |
