Managed Care Coordinator ( Provider Enrollment )
About The Position
Better at Work. Better at Life. When you work at St. Jude, you’ll join a highly collaborative work culture that inspires you every day to be your best. With opportunities for learning and growth, you can shape a career path that is right for you while also enjoying all the benefits and stability of working for a world-class institution. This includes work-life balance with generous paid time-off and on-campus conveniences that make life a little easier. Join us and you’ll quickly see why St. Jude is consistently ranked by our employees on Glassdoor as a “Best Place to Work.” The Senior Managed Care Specialist (Provider Enrollment) is responsible for managing provider enrollment duties and tasks, implementing and maintaining all data and activities related to the enrollment of hospital employed or contracted physicians into all contracted insurance programs, including State Medicaid programs. Their primary goal is to ensure efficient and cost-effective healthcare delivery while maintaining high-quality standards. This position requires minimum of 2 days/week onsite.
Requirements
- High school diploma/GED required.
- Minimum Requirement: 4+ years of experience in a healthcare, academic or research setting.
- Experience in healthcare office environment with some understanding of managed care contract and reimbursement models.
- Manage denial issues related to contractual, enrollment or credentialing issues in a timely manner; monitor own delivery for compliance with overall guidelines, policies & procedures.
- Proven performance in an earlier role.
Nice To Haves
- Experience with EPIC and CREDENTIALSTREAM preferred.
Responsibilities
- Independently execute and manage managed care tasks within own area of responsibility (e.g., provider enrollment and credentialing, claims, payor issues).
- Work closely with internal and external teams (e.g., clients, customers) to coordinate, clarify information, and resolve issues.
- Support payer communications efforts (e.g., new publications, guidelines) and other supportive documentation.
- Manage denial issues related to contractual, enrollment or credentialing issues in a timely manner; monitor own delivery for compliance with overall guidelines, policies & procedures.
- Perform other duties as assigned to meet the goals and objectives of the department and institution.
- Maintains regular and predictable attendance.
Benefits
- Generous paid time-off
- On-campus conveniences
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
High school or GED
