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Managed Care CTPN Coordinator

Req #: 17012516
Location: San Marcos, TX
Job Category: Managed Care
Organization: Central Texas Medical Center
Potential Referral Bonus: $

 Central Texas Medical Center
As a member of Adventist Health System, we believe that total health is achieved through a balance of physical, mental, social and spiritual well-being. With each patient’s unique circumstances in mind, our multi-disciplinary care teams provide a vast array of services, combining state-of-the-art technology with a personal commitment to creating an exceptional patient experience.
Our team members also enjoy outstanding care in the form of comprehensive health benefits, a friendly, faith-based work environment, and plenty of opportunities to learn and grow. In addition to earning the Gallup Great Workplace Award six years in a row, we have received a Mother-Friendly Worksite designation from the Texas Department of State Health Services.
Our 178-bed hospital includes a Level IV Emergency and Trauma Center, Women’s Center, Level II NICU, Sleep Improvement Center, Institute for Advanced Wound Care Healing, Rehabilitation Institute, home health and hospice care. Through our CREATION Health Institute, we also play an active role in offering free health education and community events to help support a healthy lifestyle.
You will be responsible for:
  •  Assist with maintaining all managed care contract and provider files and scheduling provider orientations and in-services
  • Coordinating and preparing for CTPN Board Meetings including completing minutes of those meetings as requested.
  • Conduct fee schedule analysis and create sample fee schedules for the CTPN board and committees and providers once contracts are approved and executed by the board. 
  • Understanding industry standard reimbursement and coding procedures including Medicare/RBRVS, CPT coding, etc.
  • Perform data entry of provider information into the appropriate database and create reports, directories and other documents as required. 
  • Responsible for maintaining the physician database and ensuring that all payers receive additions, changes, terminations, and other pertinent managed care information. 
  • Provides training and support to CTMC PFS department and CTPN providers regarding managed care contracts, co-plans, and any managed care related issues affecting these respective staff members.
  • Act as a provider/community relations contact for CTPN. 
  • Provide regular reports and feedback to Director on all provider relation’s contacts. 
  • Support managed care activities for Live Oak Health Partners and the Central Texas Healthcare Collaborative as directed.
  •  Attend all necessary in-services, seminars, and meetings as required. 
What will you need?
  • Bachelor’s degree (BA) from a four-year college or university
  • Two to three years related experience and/or training in the area of managed care; or equivalent combination of education and experience 

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.
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