Managed Care Cover Letter

In response to your job posting for managed care, I am including this letter and my resume for your review.

In my previous role, I was responsible for proof of concepts (POCs) demonstrations and presentations based on customer’s business, IT infrastructure, strategy in support of Managed Services offering and go to market strategy.

I reviewed the requirements of the job opening and I believe my candidacy is an excellent fit for this position. Some of the key requirements that I have extensive experience with include:

• Proven experience leading and building effective teams
• Or Comparable combination of education and experience
• Experience negotiating managed care contracts with third party payers regarding physician professional service compensation issues
• Extensive knowledge of design software and Microsoft Office Suite computer programs preferred
• Computer literate with MS Office Excel and Word
• Knowledge of the methods and techniques used for skill and career development
• Knowledge of health insurance products, market segments and marketplaces
• Knowledge of managed care practices/principles, payer reimbursement methodologies with acute care providers

I submit this application to express my sincere interest in the managed care position.

In my previous role, I was responsible for expert subject matter knowledge in all aspects of the managed services portfolio within the insurance services business domain.

Please consider my experience and qualifications for this position:

• Knowledge of Access, Word and Excel
• Audit supervisory experience of healthcare or governmental agencies preferred
• Some experience with Medical Billing
• Thorough knowledge of all Hospital, Medical Group, and IPA contracts
• Knowledge of State, Federal and Regulatory requirements
• Contracting experience or understanding of managed care systems preferred
• Extensive knowledge of Microsoft Word, Excel, Access and database applications
• Able to develop and maintain an implementation tracking system

I submit this application to express my sincere interest in the managed care position.

In my previous role, I was responsible for education and training to sales and managed care staff regarding all aspects of managed care.

Please consider my experience and qualifications for this position:

• Able to work under pressure with little or no supervision
• Knowledge in the area of financial analysis and managed care terms
• Managed Care Services and/or Operations background
• Experience with Data Analysis and Provider Relations
• Direct contact experience with customers preferred
• Working knowledge of Medicaid, Beneficiary and Managed Care processes, policies and system logic
• KEES knowledge preferred
• Microsoft Office (Outlook, Word, Excel), proficient knowledge preferred

I am excited to be applying for the position of managed care. Please accept this letter and the attached resume as my interest in this position.

Previously, I was responsible for technical guidance regarding Managed Care issues to internal stakeholders (operations, billing, and market development, medical, etc.).

I reviewed the requirements of the job opening and I believe my candidacy is an excellent fit for this position. Some of the key requirements that I have extensive experience with include:

• Medical Bill review knowledge, including CPT and ICD-10 coding and multi-state fee schedules, preferred
• Understanding of complex financial reimbursement methodologies used in contracting such as CMS DRG’s, Revenue Codes, APC’s, RBRVS, and ASC Groupers
• Basic knowledge of access or SQL
• Prior experience in hospital or health plan financial analysis, or equivalent experience preferred
• Knows/has modeled/worked with health plan/hospital and physician managed care commercial and Medicare reimbursement methodologies and terminology
• Proven interest in the health services industry
• Aptitude to work in a variety of functions and environments
• Basic understanding of Managed Care and contract terms

I submit this application to express my sincere interest in the managed care position.

In my previous role, I was responsible for expert subject matter knowledge and methodology in all aspects of the managed services portfolio within the insurance services business domain.

My experience is an excellent fit for the list of requirements in this job:

• High energy and willingness to address the high volume of contract processing work
• Highly skilled in systems - intermediate to advance in Word, Excel (knowledge of Macros, Pivots, and Formulas), MS Access (expertise of 7/8 out of 10) and/or SQL (stored procedures, table manipulation) relational database design
• Experience in financial analysis, working knowledge of managed care operations including capitation, over-payment recovery, budgeting, business and process analysis
• Able to comprehend health plan contracts regarding capitation, insured services, risk pools and DOFR issues
• Mathematical aptitude, solid analytic skills and follow through to completion of projects
• IDX or Epic experience
• Experience in translating contracts to system models preferred
• Knowledge of payor reimbursement methodologies