Client Services Representative, Managed Care

Job Description

Position Summary

Why You’ll Love Working in This Position:

• Limitless Growth: Join a rapidly expanding company where top performers are recognized and promoted. At Cedar Gate, your career potential is only limited by your ambition.
• Meaningful Work: We prioritize both employee well-being and delivering exceptional results for clients, revolutionizing healthcare.
• Flexible Work Life: Enjoy our hybrid remote schedule, which offers flexibility to balance your work productivity and dynamic personal life.
• Rewarding Culture: Work alongside a high-performing, supportive team that celebrates success together.

Summary
Join Cedar Gate Technologies, an IQVIA business, as a Managed Care Services Representative! We’re looking for a dynamic new employee to help shape and manage our provider, payer, and facility contracts. In this role, you’ll develop, negotiate, implement, monitor, and optimize managed care agreements that support our growth and quality of care. You’ll stay on top of industry trends, communicate contract changes across the organization, and analyze performance data to ensure agreements deliver the expected results.

As a Managed Care Services Representative, you’ll also collaborate closely with internal teams, clients, payers, and providers, building strong relationships and preparing presentations – with the chance to lead or co-present on key initiatives.

Roles & Responsibilities

• Act as a key liaison between internal teams, providers, and payers — resolving managed care issues, assisting with provider communications, and researching claims to maintain strong relationships.
• Collaborate with Team members to manage and maintain our Center of Excellence programs, including member education, helpline, enrollment, and reporting.
• Support clients, providers, and payers with a focus on timely and effective inquiry resolution.
• Build and nurture positive relationships with providers, payers, and internal stakeholders to support seamless operations.
• Research managed care trends and benchmarks to provide analysis and recommendations.
• Prepare data and insights to support negotiations with payers, employers, and providers; present findings to senior leadership.
• Collaborate with team members and department leadership to prepare and present documentation for Committee and Board meetings, ensuring accuracy and compliance.
• Assist with the review of payer and provider agreements and help develop negotiation strategies.
• Prepare and present quarterly payer