Managed Care Coordinator (Project Management)

• Managed Care 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.
• 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.
• Coordinates carefully with the Managed Care leaders to maintain and build new payor relationships with the Veterans Administration, or other government payors by registering and renewing facilities with SAM.gov, maintaining intricate data record to track registration and status.
• Worth with 3rd party credentialling platforms like MNS, to 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, and all other duties as assigned.