Senior Managed Care Associate (Remote)

Aeroflow Health – Senior Managed Care Associate

About Aeroflow Health: Aeroflow Health is a leading provider of durable medical equipment and healthcare solutions, dedicated to improving the quality of life for patients nationwide. We specialize in offering a wide range of products and services, including sleep apnea devices, breast pumps, lactation and nutrition education, and incontinence supplies. With a commitment to exceptional customer service and streamlined processes, Aeroflow Health partners with healthcare professionals and insurance providers to deliver personalized care and support.

The Opportunity: The Senior Managed Care Associate is a key leader within the Managed Care Contracting team. While not a direct supervisor, this role plays a critical part in training and supporting the team and managing daily operations. The Senior Managed Care Associate will oversee key functions related to credentialing, lead training initiatives, and serve as a point of contact for team members. This role is integral in ensuring that all providers, including Lactation Consultants and Registered Dietitians, have the appropriate insurance agreements to offer services to our patients through telehealth.

Your Primary Responsibilities:

• Team Leadership and Support:
• Lead the training of new Managed Care team members and ensure training materials are up-to-date for effective learning.
• Work independently while supporting the manager in training and developing new employees.
• Monitor the day-to-day workings of the Credentialing Specialist(s), ensuring that credentialing tasks are completed accurately and efficiently.
• Meet with the Credentialing Specialists to provide guidance and support with questions.
• Mentor the Managed Care Contracting team members with questions, offering support on processes and problem-solving as needed.
• Monitor credentialing requests made by our Contracting Team and ensure that CAQH updates are completed and processed by the Credentialing team in a timely manner.
• Support with contracting application process by reviewing completed applications when necessary
• Attend and participate in Write-Off Meetings, and be the main point of contact for M&B Billing when it comes to claims write offs for testing payers
• Collaborate with internal teams and health plans to ensure smooth credentialing and contracting processes.
• Be a strong leader and support to all functions of Contracting and Credentialing for the team
• Develop and streamline internal processes to enhance operational efficiency, specifically within the contracting team.

• Contracting and Credentialing:
• Meet objectives as outlined in the Managed Care Contracting Monthly Objectives.
• Review health plan reimbursement and coverage policies related to lactation services.
• Manage the contracting process for all Aeroflow Connect Lactation Consultants.
• Build and maintain strong relationships with health plans to ensure streamlined contracting and credentialing processes.
• Engage, educate, and problem-solve with new and existing health plan partners to resolve issues and improve processes.
• Collaborate and work cross functionally with sales, account management, and payer relations on contracting initiatives
• Communicate any credentialing or contracting issues to leadership in a timely and effective manner.
• Coordinating provider enrollments and terminations with Medicare, Medicaid, and Commercial insurances.
• Ensure compliance with HIPAA standards and departmental policies.
• Employee has an individual responsibility for knowledge of and compliance with laws, regulations, and policies.
• Compliance is a condition of employment and is considered an element of job performance
• Maintain HIPAA/patient confidentiality
• Regular and reliable attendance as assigned by your schedule
• Other job duties assigned
  

Required Qualifications:

• High school diploma or equivalent.
• Requires 4+ years of relevant work experience in a corporate setting
• In-depth knowledge of payer systems, insurance groups, and reimbursement procedures, with proven ability to synthesize information and troubleshoot issues effectively.
• Strong customer service skills, with the capacity to provide exceptional service to patients.
• Excellent communication skills, demonstrated in interactions with coworkers and managers.
• Highly effective presentation skills
• Consistent track record of exceeding performance goals.
• Proficiency in MS Office (Word, Outlook, Excel) and Google Suite (Docs, Sheets, Drive).
• Ability to work independently, manage multiple tasks, and thrive in a dynamic environment.
  
  

You Might Also Have:

• Billing knowledge and experience are a plus.
• Previous experience with Adobe Suite and Docusign is advantageous but not required.
• Knowledge of SQL and Microsoft Access
  
  

The Type of Person We Want

• Well-seasoned — someone who’s been in a role similar to this and several years experience in a corporate environment.
• Independent problem-solver — you can be handed goals and run with them, not waiting for step-by-step direction.
• Mentor mindset — naturally looks after peers, answers questions, and lifts others up (360° leadership).
• Thick-skinned with feedback — can take input from leadership and adjust quickly.
• Corporate savvy — understands how to navigate a growing company with competing priorities.
• Persistent — the “squeaky wheel” who pushes back with payers until clarity is achieved
• Proactive and curious — always looking for policies, new payer opportunities, and ways to grow Aeroflow’s footprint in the lactation market.
• Trusted partner — someone leadership can fully count on to represent the team well, both internally and externally.
  
  

What We Look For:

We are looking for highly motivated, talented individuals who have the ability to:

• Think outside of the box, problem solve, and work independently.
• Collaborate across multiple departments to get initiatives completed.
• Understand their goals and know what it takes to meet them.
• Grow with our company, take on new challenges, and be flexible.
  
  

What Aeroflow Offers

Competitive Pay, Health Plans with FSA or HSA options, Dental, and Vision Insurance, Optional Life Insurance, 401K with Company Match, 12 weeks of parental leave for birthing parent/ 4 weeks leave for non-birthing parent(s), Additional Parental benefits to include fertility stipends, free diapers, breast pump, Paid Holidays, PTO Accrual from day one, Employee Assistance Programs and SO MUCH MORE!!

Here at Aeroflow, we are proud of our commitment to all of our employees. Aeroflow Health has been recognized both locally and nationally for the following achievements:

• Family Forward Certified
• Great Place to Work Certified
• Inc. 5000 Best Place to Work award winner
• HME Excellence Award
• Sky High Growth Award
  
  

If you’ve been looking for an opportunity that will allow you to make an impact, and an organization with unlimited growth potential, we want to hear from you!

Aeroflow Health is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.