Managed Care Coordinator

SPHS-Managed Care Services

The Managed Care Coordinator will:

Responsible for managing the Accountable Care Organizations, Value Based Programs and payer relations; daily reviewing of our population health module, working closely with Executive Directors and practice site managers on these programs.

• Deploy necessary education, services, and tools to achieve positive outcomes and practices' defined goals for the ACO and Value Based Programs
• The coordinator is the main point of contact for the ACO and Value Based Programs as well as the Executive Directors and Practice Site Managers.
• Disseminates payer reports on a monthly basis, for practice performance and gap closure from the ACO and Value Based Programs.
• Ability to collect, analyze and evaluate data from the ACO, Value Based Programs and the SPUH organization quality reports to develop and recommend improvement efforts.
• Establish and Maintain relationship with the ACO, Value Based Programs teams, and practice teams.
• Effectively measure clinical quality data through manual and electronic chart audit.
• Supports management in contracting duties.
• Other duties.
  
  

Prepares correspondence internally and externally

Documents all revenue from value based care and ACO

Fulfills all compliance responsibilities related to the position.

Maintains appropriate confidentiality of all documents.

Requirements:

• Bachelor’s Degree in Healthcare Administration, Finance, or Public Health; or 3-5 years of experience in network management, Accountable Care Organizations with knowledge of value based programs, physician contracting and/or credentialing desired as well as working knowledge of CAQH (Council of Affordable Quality Healthcare) online physician credentialing and Microsoft Office.
• Must be detail orientated, organized, and maintain strict confidentiality.
• Must have excellent communication skills both verbal and written.
  
  

Salary Range: 68,266.00 - 112,632.00 USD

We offer competitive base rates that are determined by many factors, including job-related work experience, internal equity, and industry-specific market data. In addition to base salary, some positions may be eligible for clinical certification pay and shift differentials.

The salary range listed for exempt positions reflects full-time compensation and will be prorated based on employment status.

Saint Peter's offers a robust benefits program to eligible employees that will support you and your family in working toward achieving and maintaining secure, healthy lives now and into the future. Benefits include medical, dental, and vision insurance; savings accounts, voluntary benefits, wellness programs and discounts, paid life insurance, generous 401(k) match, adoption assistance, back-up daycare, free onsite parking, and recognition rewards.

You can take your career to the next level by participating in either a fully paid tuition program or our generous tuition assistance program. Learn more about our benefits by visiting our site at Saint Peter's .