AdventHealth University

Managed Care Coordinator

AdventHealth University$56K — $104K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 5-7 years of experience in managed care or related roles preferred.
  • 3+ years of managed care experience required.
  • Strong understanding of managed care payer contracts and requirements.
  • Familiarity with healthcare and hospital operations essential.
  • Bachelor's degree preferred from a four-year college or university.

Responsibilities

  • Analyze managed care contracts for compliance and standards.
  • Negotiate favorable reimbursement rates with payors.
  • Review and update fee schedules according to current terms.
  • Communicate contract updates to internal departments.
  • Collaborate with clinical teams to enhance reimbursement processes.
  • Monitor payor compliance and address discrepancies promptly.
  • Build relationships with payors for effective contract management.

Benefits

  • Full time, day shift position.
  • Opportunities for professional development and training in managed care processes.
Full Job Description
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

About AdventHealth University

AdventHealth University is a private university in Orlando, Florida. It was founded in 1992 and is affiliated with the Seventh-day Adventist Church. The university offers undergraduate and graduate degree programs in various fields including nursing, radiography, and sonography. AdventHealth University is accredited by the Southern Association of Colleges and Schools Commission on Colleges.
Learn more about AdventHealth University
Size
1,000 employees
Industry

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