New

Managed Care Coordinator

Cone Health

United States, North Carolina, Greensboro

Jan 17, 2025

The Managed Care Coordinator is responsible for accurately analyzing, implementing and monitoring Managed Care contractual relationships. Working under limited supervision, this role resolves problems between the organization and payers.

Resolves departmental and divisional conflicts related to managed care, bringing in senior staff, if necessary, to reach a conclusion that benefits the organization as much as possible.
Leads joint operating committee meetings with payers to include holding both the organization and the payer accountable for resolving conflicts.
Negotiates single case agreements with payers and ensures that payment is received.
Responsible for coding of contract databases, development, performance, and documentation of tasks for the appropriate contract management applications.
Performs other duties as assigned.

EDUCATION:

Required: Associate's Degree
Preferred: Bachelor's Degree

EXPERIENCE:

Required:
Associates, requires 5 years of Managed Care experience
Bachelors, requires 3 years of Managed Care experience
Juris Doctor, requires 1 year of legal experience

LICENSURE/CERTIFICATION/REGISTRY/LISTING:

Equal Opportunity Employer At Cone Health, we strive to create a welcoming atmosphere that celebrates a diverse and unique workforce. We believe in offering equal opportunities for employment to all applicants and employees, regardless of their race, religion, age, sex, sexual orientation, gender identity, veteran's status, ethnicity, national origin, disability, color, or any other characteristic protected by law. Our hiring and employment choices are based on each individual's qualifications, skills and performance. We believe that by embracing the diversity of our team, we can better serve our patients, communities and each other.