Managed Care Coordinator
Ardent health Provider
Overview Ardent Health Services (AHS) is a national health care services company headquartered in Nashville, TN. Through its subsidiaries, Ardent owns and operates nearly 200 sites of care. Our subsidiaries own and operate hospitals and multispecialty physician practices in six states. Ardent includes 30 hospitals, 4,423 patient beds, 23,000 employees, and 1,700 employed physicians. Within the industry, we are noted for recognizing that every hospital is as unique as the community it serves. This in-depth understanding of how health care works at the local level is one of our great strengths. POSITION SUMMARY The Managed Care Coordinator position is a coordination of a variety of activities working with internal and external Ardent team members. Responsibilities Maintain current knowledge of and interprets applicable Federal and State laws, rules and regulations pertaining to managed care. Reviews and evaluates program design options and recommends preferred options for all markets. Collaborates with management to discuss managed care contracts and resolve issues pertaining to managed care contract issues. Writes managed care plans and modifies as needed and obtains requisites approvals from managed care leadership. Direct training sessions relative to manage care contracts for revenue cycle and case management, administrators, providers and staff. Assists with the education of providers on all changes to any managed care contracts to ensure provider compliance and maximum reimbursement. Maintains contacts and good professional relationships will all necessary departments, payors, administrators, and partners. Is the liaison between Revenue Cycle (out of network or denials) and Case Management and Payors, update Managed Care team on trending issues for all Ardent Markets Works with revenue cycle to ensures change of demographics when applicable on facilities. Creates and maintains the Contract Matrix and Client for all Ardent Markets and Distributes to approved parties from Managed Care Director. Qualifications Education & Experience: Bachelor's degree or 3 years medical office or payor experience. Experience in communicating with professionals, conflict resolution. Healthcare/medical office experience. Knowledge, Skills & Abilities: Strong Microsoft Office skills, including Word, Access and Excel. Good inerpersoanl and customer service skills. Good organizational and follow through skills. Ability to multi task constantly and tolerate interruptions.
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