Managed Care Coordinator
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At a glance
Requirements
Credentials this posting asks for.
Job overview
AdventHealth is hiring a Managed Care Coordinator. AdventHealth seeks a Managed Care Coordinator to analyze contracts, negotiate terms, update fee schedules, and ensure compliance with regulatory standards while collaborating with internal teams and payors.
Key focus areas include Analyze managed care contracts for compliance with standards and regulations, Negotiate contract terms with payors to secure favorable reimbursement rates, and Review and update fee schedules and contract modifications to reflect current rates.
Important skills include General Knowledge Of Healthcare, Hospital And Provider Operations, And Managed Care Payer Contracts And Operations and High Degree Of Understanding Of Managed Care Payers And Managed Care Contracting Requirements.
Skills & qualifications
Skills
Qualifications
Benefits
Full job description
Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
All the benefits and perks you need for you and your family:
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Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
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Paid Time Off from Day One
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403-B Retirement Plan
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4 Weeks 100% Paid Parental Leave
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Career Development
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Whole Person Well-being Resources
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Mental Health Resources and Support
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Pet Benefits
Schedule:
Full time
Shift:
Day (United States of America)
Address:
6061 S Willow Dr
City:
Greenwood Village
State:
Colorado
Postal Code:
80111
Job Description:
Analyzes managed care contracts to ensure compliance with organizational standards and regulatory requirements. Negotiates contract terms with payors to secure favorable reimbursement rates and conditions. Reviews and updates fee schedules and contract modifications to reflect current rates and terms. Communicates contract changes and updates to relevant internal departments and stakeholders. Collaborates with clinical and support staff to optimize reimbursement and reduce operational overhead. Monitors payor compliance with contractual obligations and addresses any discrepancies. Maintains accurate and up-to-date records of all managed care contracts and related documentation. Provides training and support to staff on managed care contract requirements and changes. Facilitates open communication and joint decision-making with payors and internal teams. Builds and maintains relationships with payors to ensure effective contract management. Resolves any issues or conflicts related to managed care contracts in a timely manner. Participates in performance improvement initiatives related to managed care processes. Other duties as assigned. Knowledge, Skills, and Abilities:
- General knowledge of healthcare, hospital and provider operations, and managed care payer contracts and operations. [Required]
- Must have a high degree of understanding of the managed care payers and managed care contracting requirements. [Required]
- Knowledge of healthcare, hospital/provider operations and managed care payer operations. [Required]
Education:
- Bachelor's [Preferred]
Field of Study:
- from a four-years college or university
Work Experience:
- 3+ years of managed care or position-related experience [Required]
- 5+ years of position-related experience [Preferred]
Additional Information:
- N/A
Licenses and Certifications:
- N/A
Physical Requirements: (Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/23km2677
Pay Range:
$56,385.46 - $104,868.08
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.
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