Managed Care Coordinator

ID 2025-31952
Location
Moses Cone Hospital
Work Location
US-NC-Greensboro
Division : Name
System Wide
Department : Name
SW-Managed Care Contract
Category
FINANCE
Position Sub-Category
FINANCE
Position Type
Full Time (40 hours/week)
Employment Type
Employee
Exempt/NonExempt
Non-Exempt
FTE
1.00
Workforce Status
Fully Remote
Work Hours
40.00
Provider Schedule (specific schedule)
Monday - Friday (8:30am - 5:00pm)
On call Required
No
Sub Category
Finance

Overview

The Managed Care Coordinator is responsible for accurately analyzing, implementing and monitoring Managed Care contractual relationships. Working under limited supervision, this role resolves problems between the organization and payers.

Responsibilities


Resolves departmental and divisional conflicts related to managed care, bringing in senior staff, if necessary, to reach a conclusion that benefits the organization as much as possible.
Leads joint operating committee meetings with payers to include holding both the organization and the payer accountable for resolving conflicts.
Negotiates single case agreements with payers and ensures that payment is received.
Responsible for coding of contract databases, development, performance, and documentation of tasks for the appropriate contract management applications.
Performs other duties as assigned.

Qualifications


EDUCATION:
Required: Associate's Degree
Preferred: Bachelor's Degree

EXPERIENCE:
Required:
Associates, requires 5 years of Managed Care experience
Bachelors, requires 3 years of Managed Care experience
Juris Doctor, requires 1 year of legal experience

LICENSURE/CERTIFICATION/REGISTRY/LISTING:

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