Managed Care Coordinator

• Be part of a practice at the forefront of cutting-edge cancer care and advanced treatments
• Access opportunities for professional growth and continuing education.
• Work alongside a collaborative and compassionate team of experts dedicated to making a difference.
• Enjoy the convenience of multiple locations throughout the Capital Region.
• Contribute to groundbreaking clinical trials that shape the future of oncology care.

• Maintain provider rosters and submit updates to payers on a monthly basis or as provider changes occur.

• Maintain provider rosters and submit updates to payers on a monthly basis or as provider changes occur.
• Coordinate enrollment and credentialing activities for newly hired physicians and advanced practice providers.
• Prioritize Medicaid credentialing and recredentialing activities to ensure timely participation and minimize reimbursement disruptions.
• Prepare and submit credentialing applications for commercial, Medicare Advantage, Medicaid Managed Care, and other third-party payers.
• Monitor application status and follow up with payers regarding pending credentialing requests.
• Maintain provider demographic information across payer databases and internal systems.
• Track recredentialing requirements and ensure timely submission of all required documentation.
• Assist with CAQH maintenance and provider attestations.

• Assist with contract implementation and maintenance activities.

• Assist with contract implementation and maintenance activities.
• Maintain managed care contract libraries and related documentation.
• Track contract amendments, fee schedules, participation status, and renewal dates.
• Support payer outreach regarding contracting inquiries and provider network participation.
• Prepare reports related to payer participation, credentialing status, and contract activity.
• Assist with special projects related to reimbursement, network expansion, and payer initiatives.

• Assist with verification of payer participation and eligibility requirements for Stem Cell Transplant and CAR-T Therapy services.

• Assist with verification of payer participation and eligibility requirements for Stem Cell Transplant and CAR-T Therapy services.
• Track network participation requirements and payer-specific transplant program approvals.
• Maintain records of Letters of Agreement (LOAs), Single Case Agreements (SCAs), and transplant network contracts.
• Monitor contract expiration dates and assist with renewals.
• Coordinate with clinical, financial clearance, and contracting teams regarding payer requirements and network status.

• Assist with payer coding research and reimbursement policy reviews.
• Track coding-related denials and reimbursement trends.