Managed Care Coordinator

1106 Portercare Adventist Health System; United States; On-site; USD 63,000 - 117,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

PTO from Day One

403(b) Retirement Plan

Parental Leave

Career Development

Well-being Resources

Mental Health Resources

Pet Benefits

Job summary

AdventHealth is seeking a skilled professional to analyze managed care contracts, negotiate terms with payors, and ensure compliance with regulatory requirements across our health system. The role collaborates with clinicians and administrative staff to optimize reimbursements and maintain accurate contract records.

The ideal candidate holds a Bachelor's degree, 3+ years in managed care, and a strong understanding of payer operations and contracting practices.

Qualifications

• General knowledge of healthcare, hospital and provider operations, and managed care payer contracts and operations.
• Required: High understanding of managed care payers and contracting requirements.
• Required: Knowledge of healthcare and payer operations.
• Required: Bachelor's degree or equivalent from a four-year college or university.
• Work Experience: 3+ years in managed care or related role.
• Preferred: 5+ years in related role.

Responsibilities

• Analyzes managed care contracts to ensure compliance with organizational standards and regulatory requirements.
• Negotiates contract terms with payors to secure favorable reimbursement rates and conditions.
• Reviews and updates fee schedules and contract modifications to reflect current rates and terms.
• Communicates contract changes and updates to relevant internal departments and stakeholders.
• Collaborates with clinical and support staff to optimize reimbursement and reduce operational overhead.
• Monitors payor compliance with contractual obligations and addresses any discrepancies.
• Maintains accurate and up-to-date records of all managed care contracts and related documentation.
• Provides training and support to staff on managed care contract requirements and changes.
• Facilitates open communication and joint decision-making with payors and internal teams.
• Builds and maintains relationships with payors to ensure effective contract management.
• Resolves any issues or conflicts related to managed care contracts in a timely manner.
• Participates in performance improvement initiatives related to managed care processes.
• Other duties as assigned.

Skills

Managed care contracts

Regulatory compliance

Negotiation

Contract administration

Education

Bachelor's degree

Job description

Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits

Schedule: Full time Shift: Day (United States of America) Address: 6061 S Willow Dr City: Greenwood Village State: Colorado Postal Code: 80111

Job Description

Posting End Date: 12/4/2026

• Analyzes managed care contracts to ensure compliance with organizational standards and regulatory requirements.
• Negotiates contract terms with payors to secure favorable reimbursement rates and conditions.
• Reviews and updates fee schedules and contract modifications to reflect current rates and terms.
• Communicates contract changes and updates to relevant internal departments and stakeholders.
• Collaborates with clinical and support staff to optimize reimbursement and reduce operational overhead.
• Monitors payor compliance with contractual obligations and addresses any discrepancies.
• Maintains accurate and up-to-date records of all managed care contracts and related documentation.
• Provides training and support to staff on managed care contract requirements and changes.
• Facilitates open communication and joint decision-making with payors and internal teams.
• Builds and maintains relationships with payors to ensure effective contract management.
• Resolves any issues or conflicts related to managed care contracts in a timely manner.
• Participates in performance improvement initiatives related to managed care processes.
• Other duties as assigned.

Knowledge, Skills, and Abilities

• General knowledge of healthcare, hospital and provider operations, and managed care payer contracts and operations.
• [Required] Must have a high degree of understanding of the managed care payers and managed care contracting requirements.
• [Required] Knowledge of healthcare, hospital/provider operations and managed care payer operations.
• [Required] Education: Bachelor's [Preferred] Field of Study: from a four-years college or university.
• Work Experience: 3+ years of managed care or position-related experience [Required]
• 5+ years of position-related experience [Preferred]

Physical Requirements:

Pay Range: $62,628.80 - $116,500.80

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Every day, our fellow team members show up to work, unified by one shared mission: Extending the Healing Ministry of Jesus Christ.

As a faith-based health care organization, our story is one of hope as we strive to heal and restore the body, mind and spirit. Though our facilities are spread across the country, this unwavering belief binds us together. Across every office, exam and patient room, we’re committed to providing individualized, holistic care. This is our Christian mission, and it inspires us to help make communities healthier and happier.