Managed Care Coordinator @ Oneoncology

Why Join Us?

• 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.

Discover your career potential with a practice dedicated to excellence and innovation.

Job Description

Pay Rate: $24-$32/hr

The Managed Care Coordinator provides administrative and operational support for provider credentialing, managed care contracting, coding compliance, and specialty program oversight. This position serves as a key resource in maintaining provider participation with commercial, Medicare, and Medicaid health plans while supporting reimbursement, contract management, and regulatory compliance initiatives. The coordinator will work closely with the Managed Care Contracting, Credentialing, Revenue Cycle, Coding, and Clinical teams to ensure accurate provider enrollment, contract tracking, and coding support.

Essential Duties and Responsibilities

Credentialing and Provider Enrollment

• 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.

Managed Care Contracting Support

• 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.

Stem Cell and CAR-T Program Support

• 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.

Coding and Medical Record Review Support

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

Minimum Requirements

Education

• Associate's degree required; Bachelor's degree preferred.
• Equivalent combination of education and healthcare experience may be considered.

Experience

• Minimum 2-3 years of healthcare experience preferred.
• Experience in provider credentialing, managed care contracting, medical billing, coding, or healthcare administration strongly preferred.
• Oncology, specialty practice, or multi-site physician practice experience preferred.

Knowledge, Skills, and Abilities

• Working knowledge of provider credentialing and payer enrollment processes.
• Familiarity with Medicare, Medicaid, and commercial payer requirements.
• Understanding of medical terminology, CPT, HCPCS, and ICD-10 coding principles.
• Strong organizational and project management skills.
• Excellent written and verbal communication skills.
• Ability to manage multiple priorities and meet deadlines.
• Proficient in Microsoft Office applications, including Excel and Word.
• Experience with credentialing systems, payer portals, and CAQH preferred.

Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Requires sitting for long periods of time. Some bending and stretching required. Adequate finger dexterity and feeling to perform keyboarding and substantial repetitive motions involving the wrists, hands and/or fingers. Requires vision and hearing corrected to normal range. Must be able to view computer screen and printed material accurately. Occasionally lifts and carries items weighing up to 40 lbs.