Managed Care Coordinator

Socket.dev; United States; On-site; USD 42,000 - 68,000; Full time

Benefits offered by this job

Health Coverage

PTO & Holidays

401(k) Plan

Employee Assistance Plan

Job summary

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

You will manage credentialing statuses, audit licenses, register facilities with SAM.gov, and coordinate with MNS for authorization and claims access. Additional contracting support and related duties are included.

Responsibilities

• Credentialing: maintain credentialing status of Skilled Nursing Facilities with Health Plans by submitting credentialing applications and required documentation timely.
• Audits of certifications and updates to Health Plans to ensure compliance.
• Assist Managed Care Department with Health Plan contracting: credentialing, filing/loading contracts, and notifying facilities.
• Register and renew facilities with SAM.gov; maintain data records to track status.
• Maintain Facility profiles and documents in Credentialing Point; assist with MNS training setup for authorization and claims access.
• Coordinate with MNS on loading new or revised credentialing documents.
• Complete Health Plan Credentialing documents in Credentialing Point.
• Provide contracting support and perform all other duties as assigned.

Job description

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 PACS

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.