Bronson Healthcare-posted 3 months ago
Full-time • Mid Level
5,001-10,000 employees

The Managed Care Payor Coordinator is responsible for organizing, monitoring and maintaining payor contracts and relationships on behalf of the Managed Care Department. This position is accountable for monitoring payor compliance to contractual terms, coordinating resolution of payor issues, holding routine payor meetings and annual seminars to facilitate problem resolution and education, developing managed care tools applicable to improving the performance of the revenue cycle process, providing educational resources pertaining to payor activities to internal customers, and championing departmental improvements related to better serving our internal customers. The Managed Care Payor Coordinator serves as the primary contact to lead, triage and/or resolve complex payor-related issues from internal customers, external vendors, governmental agencies and attorneys. This position will take initiative to collaborate with effected internal departments to understand root causes in an effort to improve performance and processes. The Managed Care Payor Coordinator shall maintain the subject matter expertise relative to the terms and provisions negotiated in Bronson’s managed care payor contracts. This position is accountable for developing and building relationships with key revenue cycle stakeholders in order to assist with identifying opportunities to improve reimbursement and achieve departmental goals. The Managed Care Payor Coordinator will have the autonomy to provide internal education and support by developing, managing and implementing programs, resources and tools to inform and guide Bronson employees on payor guidelines, rules and contract terms.

  • Organizes, monitors and maintains all Managed Care Payor Contracts.
  • Provides input into the negotiation process as a result of feedback from revenue cycle stakeholders.
  • Facilitates single case agreements for VP approval.
  • Manages the payor contract management database and reporting process.
  • Works collaboratively with key stakeholders to coordinate communication of contract terms and provisions.
  • Develops and implements a system wide process for educating teams on managed care payor rules and requirements through collaboration and feedback from these teams.
  • Develops payor scorecards and/or other reporting mechanisms to monitor overall payor performance in accordance with contractual obligations.
  • Coordinates and leads the agenda and materials for routine payor meetings.
  • Works with the team to organize and lead annual payor education seminars.
  • Researches payor trends and issues, collaborating with internal departments to facilitate resolution.
  • Researches medical coverage policies to inform business development efforts.
  • Understands key contract provisions for all negotiated payor contracts.
  • Bachelor's Degree in a related field such as nursing, finance, medical records, patient accounting, or business OR experience equivalent to this degree of at least 15 years in a related field.
  • Background in credentialing and contracting with managed care payors is strongly preferred.
  • Background in patient accounting, billing, contract negotiation or finance administration is preferred.
  • Advanced analytical and problem solving skills.
  • Understanding of managed care principles, payor contracts and healthcare billing requirements.
  • Strong interpersonal skills, professionalism and cooperative behaviors at all levels of the organization.
  • Demonstrates initiative to continually enhance understanding of the changing healthcare market.
  • Public speaking skills and expertise in leading teams.
  • Exhibits ability to work independently and is self-directed.
  • Proficient in the use of computer applications.
  • Advanced skills in MS Word and MS Excel programming, and comfortable navigating database queries and management preferred.
  • Experience with public speaking and presenting to groups is highly preferred.
  • Excellent human relations skills with the ability to work constructively with key revenue cycle process stakeholders, physicians, and office staff.
  • Community-owned, not-for-profit health system.
  • Largest employer and leading healthcare system in southwest Michigan.
  • High quality standards for patient care.
  • State-of-the-art technology and evidence-based processes.
  • Ranked by Forbes as one of America’s Best-In-State Employers (2022-23).
  • Ranked by Newsweek as one of America’s Greatest Workplaces for Women (2023).
  • Ranked by the National Association for Business Resources as one of the 2023 Top 101 Best and Brightest Companies to Work For.
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