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. Provide support for daily operations and ongoing maintenance of duties related to BSA Provider Network
2. Maintain awareness of applicable Federal and State laws, rules and regulations pertaining to managed care, including applicable BSAPN policies & procedures, orders, and regulations.
3. Enters managed care contracts into contract database software, uses the approved naming conventions. Updates contract meta-data "tags" to enable efficient searches of database.
4. Processes and distributes negotiated reimbursement rates for Ardent providers to contract loading staff
5. Serves as a liaison between Payers, Credentialing, Provider Enrollment, and Revenue Cycle on operational issues such as provider loading, Tax ID numbers, and effective dates
6. Creates and maintain and distribute the Contract Matrix and Client for all Ardent Markets.
7. Works collaboratively with internal partners to ensure change of provider demographic and loading information when needed.
8. Participates in monthly plan payer meetings, maintains awareness of market contracts
9. Supports projects, as requested, related to contract research
10. Maintains professional relationships will all necessary departments, payors, administrators, and partners.

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.