Managed Care Coordinator

adventhealth; Biñan; On-site; PHP 3,102,000 - 5,768,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

Disability insurance

Paid time off

403(b) retirement plan

Parental leave

Career development

Well-being resources

Mental health resources

Pet benefits

Job summary

AdventHealth in Maitland, Florida is seeking a contract-focused analyst to manage and optimize payer contracts. You will analyze agreements, negotiate terms with payors, and keep fee schedules updated to reflect current rates and regulations.

You will collaborate with clinical and support teams to maximize reimbursement while ensuring compliance and accurate record-keeping across all contracts.

Qualifications

• General knowledge of healthcare, hospital and provider operations and managed care payer contracts.
• Understanding of managed care payers and contracting requirements.
• Knowledge of healthcare and hospital/provider operations.

Responsibilities

• Analyzes managed care contracts to ensure compliance with standards and regulatory requirements.
• Negotiates contract terms with payors to secure favorable reimbursement rates.
• Reviews and updates fee schedules and contract modifications to reflect current rates.
• Communicates changes to internal departments and stakeholders.
• Collaborates with clinical and support staff to optimize reimbursement and reduce overhead.
• Maintains records of all contracts and related documentation.

Skills

Managed care contracts

Healthcare payer operations

Negotiation skills

Education

Bachelor's degree

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

• Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
• Paid Time Off from Day One
• 403-B Retirement Plan
• 4 Weeks 100% Paid Parental Leave
• Career Development
• Whole Person Well-being Resources
• Mental Health Resources and Support
• Pet Benefits

Schedule

Full time

Shift

Day (United States of America)

Address

2600 LUCIEN WAY

City

MAITLAND

State

Florida

Postal Code

32751

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.

Knowlege, 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]

Physical Requirements

(Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/23km2677

Pay Range

$49,718.59 - $92,468.74

Background Screening Requirement (Florida Law)

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse: https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.