Managed Care Coordinator

Ardent Health is a leading provider of healthcare in growing mid-sized urban communities across the U.S. With a focus on people and investments in innovative services and technologies, Ardent is passionate about making healthcare better and easier to access. Through its subsidiaries, Ardent delivers care through a system of 30 acute care hospitals, 24,000+ team members and more than 280 sites of care with over 1,800 affiliated providers across six states.

POSITION SUMMARY:

The Managed Care Coordinator is responsible for overseeing managed care program compliance and contract administration across all markets.

1. Maintains current knowledge of and interprets applicable Federal and State laws, rules and regulations pertaining to managed care.
2. Reviews and evaluates program design options and recommends preferred options for all markets.
3. Collaborates with management to discuss managed care contracts and resolve issues pertaining to managed care contract issues.
4. Writes managed care plans and modifies as needed and obtains requisites approvals from managed care leadership.
5. Directs training sessions relative to manage care contracts for revenue cycle and case management, administrators, providers and staff.
6. Assists with the education of providers on all changes to any managed care contracts to ensure provider compliance and maximum reimbursement.
7. Maintains contacts and good professional relationships will all necessary departments, payors, administrators, and partners.
8. Acts as a liaison between Revenue Cycle (out of network or denials) and Case Management and Payors, update Managed Care team on trending issues for all Ardent Markets
9. Works with revenue cycle to ensures change of demographics when applicable on facilities.
10. Creates and maintains the Contract Matrix and Client for all Ardent Markets and Distributes to approved parties from Managed Care Director.

Education & Experience:

• Bachelor's degree in Healthcare Administration or related field of study.
  • Additional years of experience may substitute for the required education on a year-for-year basis.
• 3+ years Managed Care or Insurance experience.
• Experience in communicating with professionals, conflict resolution.
• Healthcare/medical office experience, preferred.

Knowledge, Skills & Abilities:

• Strong Microsoft Office skills, including Word, Access and Excel.
• Good interpersonal and customer service skills.
• Good organizational and follow through skills.
• Ability to multi task and tolerate interruptions.