Managed Care Coordinator

PACS Group (United Kingdom); United States; In loco; USD 55.000 - 85.000; Tempo pieno

Vantaggi offerti da questo lavoro

Health insurance

PTO and holidays

401(k) plan with company contributions

Descrizione del lavoro

PACS Group is seeking a Specialist/Coordinator to manage contracting platforms and credentialing submissions for affiliated facilities within its Managed Care operations. You will educate teams on accessing contracts and maintain compliance across credentialing activities.

Responsibilities include maintaining Health Plan credentialing status, loading contracts, registering facilities with SAM.gov, and coordinating with MNS and training teams to ensure timely access to contracts.

Competenze

• Knowledge of healthcare credentialing processes.
• Experience with health plans and contracting.
• Strong attention to detail and compliance.

Mansioni

• Maintain credentialing status of facilities with Health Plans by submitting credentialing applications and required documents.
• Manage and audit credentialing records and licenses to ensure compliance.
• Assist Managed Care Department with Health Plan contracting, filing, and notifying facilities.

Conoscenze

Credentialing knowledge

Healthcare administration

Communication

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.

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.