Managed Care Coordinator

PACS in; Salt Lake City (UT); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Health Coverage

PTO and Holidays

Health Savings Accounts (HSA) and Flex

401(k) with company contributions

Employee Assistance Plan (EAP)

Job summary

PACS is seeking a Managed Care Coordinator to maintain contracting platforms and support the Managed Care Department with Health Plan applications and credentialing documentation. The role focuses on credentialing for Skilled Nursing Facilities, coordinating with Health Plans, and loading contracts while ensuring timely filings and compliance.

It also covers MNS training setup and data management across facilities.

Qualifications

• Experience maintaining credentialing status with Health Plans and submitting required documentation.
• Auditing certifications and updating Health Plans for compliance.
• Coordinate credentialing across facilities and contracts.

Responsibilities

• Maintain credentialing status for facilities with Health Plans; submit applications and docs timely.
• Manage the Credentialing Point data and load contracts properly.
• Register and renew facilities with SAM.gov; track status.
• Assist with Health Plan contracting process and facility notifications.
• Support MNS setup and training for authorization and claims access.
• Coordinate with MNS on loading credentialing documents and keep records updated.

Skills

Credentialing processes

Contracting support

Data management

Tools

Credentialing Point

SAM.gov

Job description

Managed Care Coordinator (Project Management)

General Purpose

The Specialist/Coordinator is responsible for maintaining contracting platforms internally and externally for PACS affiliated facilities. Directly supports the Managed Care Department by completing Health Plan applications, submitting credentialing documents, notifying facilities on contracts and providing education on accessing contracts.

Job Essentials

Credentialing:

• Responsible for maintaining credentialing status of Skilled Nursing Facilities with Health Plans by submitting credentialing applications and required documentation timely.
• Maintains shared drive that houses all facility credentials and licenses. Performs regular audits of certifications and updates Health Plans accordingly to ensure compliance.
• Assists Managed Care Department with the Health Plan contracting process, from credentialing, proper filing/loading of contracts, and notifying facility.
• Registers and renews facilities with SAM.gov, maintains an intricate data record to track registration and status.

MNS:

• Maintain Facility profiles and documents in Credentialing Point.
• Assist with setting up MNS training with facilities for authorization and claims access.
• Coordinate with MNS on loading new or revised credentialing documents.
• Complete Health Plan Credentialing documents in Credentialing Point.

Contracting support.

All other duties as assigned.

PACS is elevating healthcare by revolutionizing our approach to leadership and quality care. Guided by our core values of love, excellence, trust, accountability, mutual respect, and commitment , we strive to foster a culture of compassionate care within our teams and the communities we serve. As we grow rapidly, exciting opportunities await you to engage in impactful projects and contribute valuable insights to stakeholders nationwide.

At PACS, we believe our employees are our greatest asset. That's why we offer an exceptional benefits package designed to enhance your well-being and support your lifestyle.

Our Comprehensive Benefits Include

• Health Coverage: Enjoy medical, dental, and vision plans to keep you and your family healthy.
• PTO and Vacation: Benefit from generous paid time off and holidays to relax and recharge.
• Financial Wellness: Take advantage of Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) to manage your healthcare expenses effectively.
• Retirement Planning: Secure your future with our 401(k) plan, complete with company contributions to help you build your retirement savings.
• Support When You Need It: Our Employee Assistance Plan (EAP) provides confidential support for personal and professional challenges.

We celebrate diversity and are committed to creating an inclusive environment for all employees. We welcome applicants of every race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, and any other protected characteristic. Employment decisions are based on qualifications, merit, and business needs.