Managed Care Coordinator
About The Position
The Managed Care Coordinator provides operational support for all managed care functions across contracted IPAs, MSOs, and health plans. This role is responsible for assisting with credentialing submissions, monitoring IPA portal activity, pulling membership reports, tracking enrollment data, and ensuring provider alignment across all payor relationships. The Coordinator serves as a key liaison between Managed Care and external teams to ensure accurate provider assignments, panel oversight, and uninterrupted member access to care. Managed Care experience is desired, including familiarity and health plan engagement.
Requirements
- Minimum 1 year of experience in medical managed care, IPA operations, or provider credentialing.
- Experience navigating health plan and IPA portals.
- Strong organizational skills and ability to manage multiple timelines.
- High attention to detail and follow-through.
- Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access.
- TB clearance, to be renewed every year.
- Vaccines and boosters as needed.
Nice To Haves
- Knowledge of Medi-Cal, Medicare Advantage, and commercial HMO products preferred.
- Experience submitting credentialing applications to IPAs/MSOs a plus
- FQHC or Primary Care experience preferred
- Basic & complex medical coding & medical terminology preferred
Responsibilities
- Prepare, submit, and track credentialing applications to IPAs and MSOs (medical, behavioral health, and dental).
- Support credentialing inquiries.
- Assist in the onboarding of new providers and timely submission of credentialing applications.
- Complete required IPA/MSO attestations and compliance documentation.
- Attend key credentialing meetings and provide updates on application status and provider alignment.
- Attend scheduled IPA and health plan meetings related to credentialing, panel updates, and member alignment.
- Retrieve and compile monthly enrollment reports from IPA portals.
- Monitor provider panel openings/closures and notify internal teams accordingly.
- Work directly with health plans regarding member lists requiring outreach or reassignment.
- Escalate discrepancies or risk areas to CIGO as appropriate.
- Track provider assignments by IPA and health plan.
- Maintain updated records of supervising physicians for mid-level providers (NPs/PAs).
- Notify CIGO of any provider changes, terminations, supervision shifts, or allocation updates requiring review.
- Coordinate with Operations to ensure provider listings align with contracted IPA structures.
- Work closely with the Enrollment Lead to address member reassignment needs.
- Support transitions related to provider terminations, panel closures, or IPA changes.
- Assist with coordination of patient outreach to prevent disruptions in care.
- Ensure alignment between managed care updates and front-end operations.
- Maintain and update provider directory submissions/tracker for all contracted health plans.
- Ensure accurate provider data across IPA portals and health plan systems.
- Monitor and track IPA communications for policy or reporting updates.
Benefits
- Compliance with all mandated vaccinations and all boosters is a term and condition of employment.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
