Sovereign Healthcare

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Contract Coordinator, Managed Care

at Sovereign Healthcare

Pay: from $54,000/year
Posted: 2/18/2019
Job Status: Full Time
Keywords:

Job Description

Supports the Managed Care department through the development of reports, analysis of contract negotiations and existing contract performance.  Maintains the Managed Care contract and correspondence files.  Also maintains the Managed Care site on the SharePoint/ My Sovereign shared data base.

Primary Position Responsibilities:

  1. Responsible for developing and updating reports that provide needed information to both internal and external stakeholders.
  2. Create and maintain all Managed Care department contract files, both written and electronic.
  3. Responsible for maintaining all other Managed Care department work files to include the negotiation, credentialing/re-credentialing and correspondence files.
  4. Collaborates with the Revenue Cycle Management team on day-to-day operational issues to ensure all defined metrics are being met.
  5. Maintains the Managed Care site on the SharePoint/ My Sovereign shared document data base by posting and replacing documents, as needed.
  6. Works with Finance personnel to prepare and finalize all reporting needed to manage the Managed Care contracts.
  7. Manages the execution and processing of all managed care contracts, amendments and letters of agreement.
  8. Works with Sovereign personnel to resolve managed care issues involving contracts, amendments and letters of agreement that impact Operations, Finance, Billing, Collections and/or Insurance Verification.
  9. Assists in the completion and management of all credentialing and re-credentialing applications.
  10. Organizes Managed Care department meetings. This includes both internal and external meetings as well as developing agendas for these meetings.
  11. Assists other Sovereign departments with the review and interpretation of the managed care contracts, amendments and letters of agreement.
  12. Performs quality assurance evaluations to insure department compliance with company policy, best practices and established federal and state regulations.
  13. Manages special projects as assigned.

Skill / Requirements

Position Requirements

Total Education/Training/Vocational: 

 

Minimum:          High School degree with at least 5 years of experience working in a managed care / healthcare contracting department.

Preferred:           Associate or Bachelor’s Degree in Business/Finance/Management or Economics. 

 

Skills and Abilities:

  1. Proficient in all MS Office applications. Particular emphasis on MS Outlook, Word, Power Point and Excel applications.
  2. Analytical skills.
  3. Understanding of the health care industry in general and ambulatory surgical centers specifically.
  4. Knowledge and understanding of medical terminology.
  5. Knowledge of basic health insurance policies and practices.
  6. Ability to manage and organize documents, both written and electronic.
  7. Knowledge of commercial and government health plans and how to access health plan information (e.g., contacts, policies) as needed.
  8. Ability to read, understand and follow verbal and written instruction.
  9. Excellent verbal and written communication skills.
  10. Ability to handle multiple tasks in a busy environment and see them through to completion.
  11. Ability to set priorities and work independently.