UM Out-of-Network Contract Liaison

Benefits: 401(k) 401(k) matching Bonus based on performance Company parties Dental insurance Employee discounts Health insurance Opportunity for advancement Paid time off Parental leave Savings bank Training & development Vision insurance Wellness resources About the Role: MedPOINT Management is looking for a detail-oriented and driven UM Out-of-Network Contract Liaison to join our team in Sherman Oaks, CA. In this critical role, you'll serve as the bridge between utilization management and out-of-network providers, ensuring seamless contract negotiations and authorizations. If you thrive in a fast-paced managed care environment and have a passion for healthcare operations, we want to hear from you! Responsibilities: Facilitate out-of-network (OON) contract negotiations between providers and health plans Coordinate with the Utilization Management (UM) team to support OON authorization requests and approvals Communicate with out-of-network providers regarding single-case agreements and reimbursement terms Track and document OON contract statuses, agreements, and correspondence in internal systems Collaborate with claims, UM, and network development teams to resolve OON billing and authorization issues Ensure compliance with state and federal regulations related to OON services and managed care contracting Prepare and maintain reports on OON activity, trends, and cost containment outcomes Requirements: 2+ years of experience in managed care, utilization management, or healthcare contracting Familiarity with out-of-network provider negotiations and single-case agreements Knowledge of IPA, HMO, and managed care operations strongly preferred Strong understanding of medical terminology, CPT/ICD-10 codes, and authorization processes Excellent communication and negotiation skills with internal and external stakeholders Proficiency in healthcare management systems and Microsoft Office Suite Highly organized, detail-oriented, and able to manage multiple priorities simultaneously About Us: MedPOINT Management is a leading Independent Practice Association (IPA) management company based in Sherman Oaks, CA, with decades of experience supporting physician organizations across Southern California. Our clients trust us for our expertise in managed care operations, and our team members love working here for our collaborative culture, commitment to excellence, and meaningful impact on patient care. Join a company where your work truly makes a difference in the healthcare community. This is a remote position. Compensation: $75,000.00 - $85,000.00 per year