Managed Care Coordinator

PACS; Salt Lake City (UT); In loco; USD 52.000 - 76.000; Tempo pieno

Vantaggi offerti da questo lavoro

Health coverage

PTO & Holidays

HSA & FSA

401(k) plan

Employee assistance program

Descrizione del lavoro

PACS is seeking a Specialist/Coordinator to maintain contracting platforms for affiliated facilities and support the Managed Care Department with Health Plan applications, credentialing documents, and contract education.

You will manage credentialing status with Health Plans, maintain credentialing records, assist with contract loading, register facilities with SAM.gov, and coordinate with MNS training and loading of documents, contributing to nationwide contracting efforts.

Competenze

• Maintains credentialing status of facilities with Health Plans by timely submission of applications and documentation.
• Performs audits of certifications and updates Health Plans to ensure compliance.
• Assists Managed Care with Health Plan contracting from credentialing to loading contracts and notifying facilities.

Mansioni

• Maintain facility credentialing status with Health Plans; submit required documentation timely.
• Maintain shared credentialing drive and audit certifications; notify Health Plans of updates.
• Assist with Health Plan contracting process, proper filing/loading of contracts, and facility notification.
• Register and renew facilities with SAM.gov; track registration/status.
• Maintain Facility profiles in Credentialing Point and assist with MNS training for authorization and claims access.
• Coordinate with MNS on loading new or revised credentialing documents; complete Health Plan Credentialing documents.

Conoscenze

Credentialing workflows

Contracting coordination

Data management

Auditing documents

Strumenti

Credentialing Point

SAM.gov

Descrizione del lavoro

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.

Join PACS: Elevate Healthcare with Us!

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.

If you're ready to make a difference and embrace our mission of creating real change, we invite you to join us at PACS. Together, let's shape the future of healthcare!

Join Our Team and Thrive!

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.

Join us at PACS and take advantage of a workplace that truly values you!

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.