Managed Care Coordinator

PACS

About The Position

The Managed Care Coordinator maintains internal and external contracting platforms for PACS-affiliated facilities and directly supports the Managed Care Department. The role completes Health Plan applications, submits credentialing documents, notifies facilities about contracts, and provides education on accessing contracts. Responsibilities include maintaining Skilled Nursing Facilities’ credentialing status with Health Plans, keeping facility credential and license records current, supporting the Health Plan contracting process, and registering and renewing facilities with SAM.gov. The role also maintains facility profiles and documents in Credentialing Point, coordinates training and document loading with MNS, completes credentialing documents, and provides contracting support. Other duties may be assigned.

Responsibilities

Submit Health Plan credentialing applications and required documentation in a timely manner to maintain Skilled Nursing Facilities’ credentialing status.
Maintain the shared drive containing facility credentials and licenses; regularly audit certifications and update Health Plans to ensure compliance.
Assist the Managed Care Department with Health Plan contracting, including credentialing, filing or loading contracts, and notifying facilities.
Register and renew facilities with SAM.gov and maintain a detailed record tracking registration and status.
Maintain facility profiles and documents in Credentialing Point.
Assist with arranging MNS training for facilities on authorization and claims access.
Coordinate with MNS to load new or revised credentialing documents.
Complete Health Plan credentialing documents in Credentialing Point.
Provide contracting support.
Perform other duties as assigned.