Managed Care Coordinator

(PACS) Providence Administrative Consulting Services, Inc.; United States; In loco; USD 42.000 - 66.000; Tempo pieno

Vantaggi offerti da questo lavoro

Health Coverage

PTO and Vacation

Financial Wellness (HSA/FSA)

Retirement Planning (401(k))

EAP

Descrizione del lavoro

PACS Group is seeking a Specialist/Coordinator to maintain contracting platforms and support the Managed Care Department with credentialing, contract loading, and education on accessing contracts.

Responsibilities include credentialing applications, maintaining facility credentials, and coordinating with Health Plans and SAM.gov registrations to ensure timely, compliant submissions.

Competenze

• Credentialing workflow management for facilities with Health Plans.
• Timely submission of credentialing applications and required docs.
• Maintain and audit facility credentials and licenses.

Mansioni

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

Conoscenze

Credentialing

Health Plans

Documentation

Audits

Contracting support

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!

• 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.

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.

PACS is revolutionizing the delivery and leadership of post-acute healthcare and support services across the country. Originally founded in 2013, the organization now consists of hundreds of independent operating subsidiaries, as well as ancillary and support services. We bring a proven model of mission-driven care that balances access to a national network of support and resources with local decision making. In addition, PACS helps connect exceptional people with premier healthcare careers across the country. We focus on finding innovative and effective team members based on their qualifications, experience, geographic preferences, and personality fit with the existing facility staff and culture.