Senior Managed Care Associate (Remote)
Aeroflow Health
Asheville, NC
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
- 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.
- 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
- 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.
- 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.
- Family Forward Certified
- Great Place to Work Certified
- Inc. 5000 Best Place to Work award winner
- HME Excellence Award
- Sky High Growth Award
Posted 2025-09-08
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