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Company name : Mitchell International
Location : United States
Position : MCO Plan Administrator (Remote)
Description :
Company Overview:
The Enlyte Family of Businesses
Mitchell | Genex | Coventry
Enlyte is the parent brand of Mitchell, Genex and Coventry, an organization unlike any other in the Property & Casualty industry, bringing together three great businesses with a shared vision of using technology innovation, clinical services and network solutions to help our customers and the people they serve. Our suite of products and services enable our employees to help people recover from challenging life events, while providing opportunities for meaningful impact and career growth.
Job Description :
This is a full-time remote position that can be located anywhere in the U.S.
The Senior Manager is responsible for the effective administration of the organization’s Certified Plan offerings and ensures compliance with various State laws as it relates to Workers’ Compensation MCO plans.
Responsible for supporting State Managed Care certifications, renewal and reporting, and the oversight of jurisdictional opportunities and requirements regarding managed care plans
Responsible to support the following relative to the delivery of Managed Care Programs and related services (Utilization Review, Case Management, & Medical Bill Review)
Product management
Certification
Regulatory compliance
Quality management
Jurisdictional & customer reporting and analytics
Network access and utilization
Responsible for interaction with Customers, Sales, Account Management, and Operations staff in providing information and presentations related to Managed Care Programs
Lead or assist in projects related to Managed Care services in conjunction with Operations, Account Management and Sales.
Assist in research and education related to Managed Care & Compliance Regulations.
Perform other functions as required for the department
Qualifications:
2+ years MCO plan administration
2+ years of experience managing people
2+ years of experience in Worker’s Comp preferred
PC literate with advanced proficiency in Microsoft Outlook, Word, and Excel
Demonstrated ability to be a self-starter, highly organized, detail-oriented, and accurate
Proven ability to handle fast-paced environment, multiple priorities, and a track record for getting results
Able to regularly exercise discretion, handle conflict and be firm when required
Ability to communicate effectively and work collaboratively with third party service providers and all levels of employees
Ability to motivate and elicit participation in programs
Demonstrated ability to analyze data and provide recommendations
Benefits : We’re committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. If you are a Colorado resident, you may request additional information about the compensation for this role by emailing: careers@mitchell.com for assistance. The Company is an equal opportunity employer, values the diversity of our workforce and the knowledge of our people. The Company does not discriminate against an applicant or employee on the basis of race, color, religion, national origin, ancestry, sex/gender, age, physical or mental disability, military or veteran status, genetic information, sexual orientation, gender identity, gender expression, marital status, or any other characteristic protected by applicable federal, state or local law. #LI-FP1 #LI-Remote #MIT
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