Managed Care Coordinator

The Managed Care Coordinator is a responsible member of a multi-disciplinary team. S/he represents AdventHealth to payors, serving to validate that payors contractual obligation in terms of updated fee schedules and modifications to contracts. S/he must manage the contracts, therefore, must have a high degree of understanding of the requirements of each Agreement for all hospital, ancillary, and physician services. In addition, s/he must communicate regularly with clinical and support staff in order to obtain the optimum reimbursement, decrease operational overhead, and maximize patient benefits. The value you will bring to the team: 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. The expertise and experiences you'll need to succeed: 3 years of managed care or position-related experience General knowledge of healthcare, hospital and provider operations, and managed care payer contracts and operations. Must have a high degree of understanding of the managed care payers and managed care contracting requirements. Knowledge of healthcare, hospital/provider operations and managed care payer operations. Preferred Qualifications: Bachelor's Degree

• 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.

• General knowledge of healthcare, hospital and provider operations, and managed care payer contracts and operations.
• Must have a high degree of understanding of the managed care payers and managed care contracting requirements.
• Knowledge of healthcare, hospital/provider operations and managed care payer operations.

• Benefits from Day One
• Career Development
• Whole Person Wellbeing Resources
• Mental Health Resources and Support

Hospitals, medical centers and facilities need more than physicians, nurses and specialists delivering care to our patients. A truly successful health care organization needs a thoughtful, dedicated, steady and experienced team working behind the scenes to make sure communities around the country receive the health care they need. If you’ve also been interested in working in the health care field but aren’t a health care provider, a corporate career at AdventHealth may just be the perfect fit. We’re a faith-based health care organization headquartered in Altamonte Springs, Florida. As a national leader in quality, safety and patient satisfaction, our 92,000 team members maintain a long tradition of whole-person health by caring for the physical, emotional and spiritual needs of every patient. Start your journey with a health care career at AdventHealth Corporate. 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. 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.