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Managed Care Coordinator

2 weeks ago

Raleigh, North Carolina, United States True Behavioral Health Lp Full time

About First Responder Health

First Responder Health is dedicated to serving those who serve others. Through our family of companies, we provide comprehensive, proactive, and reactive wellness and resilience resources exclusively for public safety professionals. Our mission is to support first responders in maintaining their mental health and well-being throughout their demanding careers.

Our family of companies includes:

  • The Counseling Team International – Culturally competent short-term counseling, critical incident debriefings, training, and pre-employment psychological testing
  • First Responder Wellness – Comprehensive inpatient and outpatient behavioral health treatment exclusively for public safety professionals, treating post-traumatic stress, alcohol addiction, anxiety, and depression
  • Shift Wellness – Retreats for trauma, resilience, and wellness specially designed for leaders, peer support teams, individuals, departments, and spouses

What sets us apart is our deep understanding of first responder culture. Our clinical and support staff includes former first responders who are intimately familiar with the unique challenges public safety professionals face. We are committed to destigmatizing mental wellness and providing culturally competent care in a safe, supportive environment.

Position Summary

The Managed Care Coordinator plays a vital role in supporting the administrative, operational, and data-related components of First Responder Health's payer contracting portfolio. This position focuses on health plan enrollment, contract documentation, credentialing coordination, and maintenance of payer records across all First Responder Health entities. In this role, you'll ensure that payer information is accurate, up-to-date, and implementable for our Admissions, Utilization Review, Billing, and Finance teams. You'll serve as the primary internal resource for contract records, fee schedules, payer communications, and enrollment status, working closely with leadership on strategic contracting initiatives.

Why Join First Responder Health?

  • Meaningful Mission: Make a direct impact on the lives of first responders and their families by ensuring access to critical mental health services
  • Collaborative Environment: Work with dedicated professionals across multiple specialized organizations within our family of companies
  • Professional Growth: Develop expertise in behavioral health contracting while working with diverse payer types including commercial insurance, workers' compensation, and EAPs
  • Values-Driven Culture: Join an organization that truly cares about the well-being of first responders and maintains the highest standards of service

Key Responsibilities

Health Plan Enrollment & Credentialing Support


• Manage the full lifecycle of payer enrollments and revalidations for clinicians and facilities across all entities


• Prepare and submit payer enrollment applications and updates


• Track enrollment status and follow up with plans until completion


• Coordinate with the Director of Admissions on payer acceptance and program availability


• Maintain credentialing timelines and ensure renewals occur on schedule

Contract Administration & Record Keeping


• Maintain a centralized repository of payer contracts, fee schedules, amendments, and contacts


• Track renewal dates and required updates


• Assist the Controller by preparing redlines and organizing documents for negotiation


• Summarize key terms for internal use


• Ensure NetSuite, Avea Office, and Kipu reflect correct payer data

Payer Communication & Issue Resolution


• Serve as day-to-day contact for payer administrative questions


• Track and distribute payer notices and updates


• Partner with Revenue Cycle Supervisor to resolve issues related to billing or enrollment


• Maintain payer requirement logs

Operational Support & Cross-Department Coordination


• Work with Admissions to verify plan participation


• Partner with Revenue Cycle on fee schedules and billing rules


• Collaborate with the CEO regarding payer information needed for new programs


• Support audit requests

Data Management & Reporting


• Maintain dashboards summarizing contracts and enrollments


• Track payer rates and ensure accurate system loading


• Prepare periodic status reports for the Controller

Qualifications

Required


• Bachelor's degree or equivalent experience


• 2-4 years of experience in payer enrollment, contract administration, credentialing, or revenue cycle


• Familiarity with behavioral health or medical billing


• Strong organizational and documentation skills


• Proficiency in Excel and healthcare portals


• Excellent written and verbal communication

Preferred


• Experience with NetSuite, Avea Office, or Kipu EMR


• Knowledge of California workers' compensation, TPAs, commercial payers, or EAPs


• Understanding of utilization management (UM) requirements

Key Competencies


• Detail-oriented with strong follow-through


• Able to maintain accurate records and meet deadlines


• Strong communicator with professional demeanor


• Good judgment in escalating issues


• Comfortable in a fast-paced environment

This position is 100% onsite at our Irvine location, Fulltime Monday through Friday, 8 hours per day.

Join us in our mission to support those who protect and serve our communities. If you're passionate about making a difference in the lives of first responders and have the skills to excel in this role, we'd love to hear from you.