Managed Care/Payer Enrollment Coordinator

2 months ago


Morgantown, West Virginia, United States Mon Health Full time

Job Summary:

The Managed Care/Payer Enrollment Specialist will play a critical role in supporting the operational activities of Payer Enrollment at Mon Health. This position will be responsible for managing accounting and information systems in support of Managed Care/Payer Enrollment, as well as developing strategies to improve reimbursement levels under managed care agreements.

Key Responsibilities:

  • Manage daily activities related to providing operational support for Payer Enrollment
  • Develop and implement strategies to improve levels of reimbursement under managed care agreements
  • Develop and guide organizational structure and processes necessary to support managed care agreements
  • Work directly with Managed Care Organizations to resolve enrollment and administrative escalations occurring with Managed Care contracts

Requirements:

  • High school diploma or equivalent required; Bachelor's degree preferred
  • One to three years of current provider credentialing experience required
  • Previous Hospital Credentialing experience required
  • Basic to working knowledge of Centers for Medicaid and Medicare and Managed Care concepts, including Managed Medicare/Medicaid requirements, Disclosure of Ownership and Control Interest, and applicable laws/statutes/regulations
  • Previous experience working with hospital contracts or demonstrated knowledge of contract principles and interpretation of contract language
  • Certified Provider Credentialing Specialist (CPCS) certificate preferred or willingness to sit for CPCS within one (1) year of hire

Working at Mon Health:

Mon Health is a leading healthcare organization dedicated to providing high-quality patient care and services. As a member of our team, you will have the opportunity to work in a dynamic and supportive environment that values innovation, collaboration, and excellence.



  • Morgantown, West Virginia, United States Mon Health Full time

    Job SummaryWe are seeking a highly skilled Managed Care/Payer Enrollment Specialist to join our team at Mon Health. This role will be responsible for managing daily activities related to providing operational support for Payer Enrollment, including managing accounting and information systems in support of Managed Care/Payer Enrollment.Key...


  • Morgantown, West Virginia, United States Mon Health Full time

    Key Responsibilities:The Managed Care/Payer Enrollment Specialist at Mon Health will be responsible for managing daily activities related to providing operational support for Payer Enrollment.This role involves managing accounting and information systems in support of Managed Care/Payer Enrollment and developing strategies for improving levels of...


  • Morgantown, West Virginia, United States Mon Health Full time

    Job SummaryWe are seeking a highly skilled Managed Care/Payer Enrollment Specialist to join our team at Mon Health. This role will be responsible for managing daily activities related to providing operational support for Payer Enrollment.Key ResponsibilitiesManage accounting and information systems in support of Managed Care/Payer EnrollmentDevelop...


  • Morgantown, West Virginia, United States West Virginia University Hospitals, Inc. Full time

    Care Management Assistant Job SummaryWe are seeking a highly skilled and detail-oriented Care Management Assistant to join our team at West Virginia University Hospitals, Inc. The successful candidate will provide administrative support to the Care Management Team, ensuring the day-to-day operational functions of the department are met in a timely manner.Key...


  • Morgantown, West Virginia, United States West Virginia University Hospitals, Inc. Full time

    We are seeking a highly skilled Care Management Assistant to join our team at West Virginia University Hospitals, Inc. The successful candidate will provide support to the Care Management Team to ensure the day-to-day operational functions of the department are met in a timely manner.This role involves collaboration with third-party payers and post-acute...


  • Morgantown, West Virginia, United States WVU Medicine Full time

    Care Management Assistant Job DescriptionWe are seeking a highly organized and detail-oriented Care Management Assistant to join our team at WVU Medicine. In this role, you will provide administrative support to the Care Management Team, ensuring the day-to-day operational functions of the department are met in a timely manner.Key...


  • Morgantown, West Virginia, United States West Virginia University Hospital, Inc Full time

    Job SummaryWe are seeking a highly skilled Pharmacy Business Coordinator to join our team at West Virginia University Hospitals. The successful candidate will be responsible for conducting payer discussions, in-house financial audits, and ensuring compliance with revenue cycle operations, third-party reimbursement procedures, and regulations.Key...


  • Morgantown, West Virginia, United States WEST VIRGINIA UNIVERSITY RESEARCH CORPORATION Full time

    About the OpportunityThe West Virginia University Research Corporation is seeking a highly skilled Patient Navigator to join our team. As a Patient Navigator, you will play a critical role in the management of patients enrolled in the CHOICE study, ensuring seamless coordination across the healthcare system.As a key member of our team, you will be...


  • Morgantown, West Virginia, United States Amedisys Full time

    About the RoleWe are seeking a skilled Registered Nurse to join our team at Amedisys, a leading provider of home health and hospice care. As a Registered Nurse, you will play a critical role in delivering high-quality patient care and collaborating with our interdisciplinary team to develop and implement effective care plans.ResponsibilitiesCoordinate and...


  • Morgantown, West Virginia, United States MedMark Services Full time

    Job Summary: MedMark Treatment Center is seeking a skilled Patient Access Coordinator to join our team. As a Patient Access Coordinator, you will be responsible for performing various administrative tasks with a keen eye for detail. Your primary responsibilities will include patient billing, verification of invoice information, maintenance of third-party...


  • Morgantown, West Virginia, United States WVU Medicine Full time

    Job SummaryWe are seeking a highly organized and detail-oriented Provider Credentialing Specialist to join our team at WVU Medicine. This role will be responsible for coordinating the credentialing process for all incoming doctors and Advanced Practice Providers (APPs), ensuring compliance with regulatory requirements and maintaining accurate records.Key...


  • Morgantown, West Virginia, United States West Virginia University Health System Full time

    Job SummaryWe are seeking a highly skilled and experienced Trauma Care Coordinator to join our team at West Virginia University Health System. The successful candidate will be responsible for coordinating trauma care management across the continuum of trauma care, including planning and implementing clinical protocols and practice management guidelines,...


  • Morgantown, West Virginia, United States West Virginia University Hospital, Inc Full time

    Care Management Assistant Job DescriptionWe are seeking a highly skilled and dedicated Care Management Assistant to join our team at West Virginia University Hospitals. As a Care Management Assistant, you will play a vital role in ensuring the day-to-day operational functions of the Care Management department are met in a timely manner.Key...


  • Morgantown, West Virginia, United States WVU Medicine Full time

    Job SummaryWe are seeking a highly skilled and experienced Trauma Care Coordinator to join our team at WVU Medicine. As a key member of our trauma care team, you will play a critical role in coordinating trauma care management across the continuum of trauma care.Key ResponsibilitiesCoordinate trauma care management across the continuum of trauma care,...


  • Morgantown, West Virginia, United States West Virginia University Hospital, Inc Full time

    About the RoleWe are seeking a highly skilled and experienced Trauma Care Coordinator to join our team at West Virginia University Hospital, Inc. As a Trauma Care Coordinator, you will play a critical role in coordinating trauma care management across the continuum of trauma care, including planning and implementing clinical protocols and practice management...


  • Morgantown, West Virginia, United States WVU Medicine Full time

    Job SummaryThis role is responsible for leading the development and implementation of managed care contracting strategies for WVU Medicine. The ideal candidate will have a strong background in healthcare contracting, negotiation, and leadership.Key ResponsibilitiesDevelop and implement managed care contracting strategies to achieve organizational...


  • Morgantown, West Virginia, United States WVU Medicine Full time

    Job SummaryWe are seeking a compassionate and skilled Spiritual Care Coordinator to join our team at WVU Medicine. As a key member of our hospice care team, you will provide spiritual support and care to patients and their families, promoting emotional and spiritual well-being in times of need.Key ResponsibilitiesMake regular spiritual care visits to...


  • Morgantown, West Virginia, United States WVU Medicine Full time

    Job SummaryWe are seeking a highly skilled and experienced Project Manager to lead the efforts of Ambulatory Operations in improving services provided by the Clinical Enterprise in its ambulatory locations. The successful candidate will have a strong background in project management, excellent communication skills, and the ability to work effectively with...

  • Project Manager

    3 weeks ago


    Morgantown, West Virginia, United States WVU Medicine Full time

    Job SummaryWe are seeking a highly skilled Project Manager to lead the efforts of Ambulatory Operations in improving services provided by the Clinical Enterprise in its ambulatory locations.Key ResponsibilitiesLead special projects and serve as the primary coordinator between multiple stakeholders, including ambulatory operations, clinical department...


  • Morgantown, West Virginia, United States CAMC Health System Full time

    Job Title: Clinical Care CoordinatorJob Summary:As a Clinical Care Coordinator at CAMC Health System, you will play a vital role in coordinating total patient-centered care, ensuring optimal service to the communities we serve. You will work closely with physicians, patients, and their families to provide exceptional care and clinical...