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What will I be doing in this role?
In collaboration with the department Senior Vice President and department directors, the Managed Care Coordinator supports the strategic, operational, and administrative functions of the Managed Care and Payer Relations department. Supports critical initiatives, contract implementation, credentialing, payer relations, and departmental compliance. Works closely with leadership to ensure department goals align with broader Health System objectives.
The Managed Care Coordinator collaborates with leadership, clinical departments, and external partners to ensure accurate documentation, timely communication, and effective execution of managed care functions. In this multifaceted role, the Managed Care Coordinator assists with payer Requests for Information (RFIs), contract documentation, and Letters of Agreement (LOAs), while also managing credentialing tasks, onboarding, and regulatory reporting. The position also supports departmental budgeting processes, provides operational support, and contributes to special projects related to payer strategy, compliance, and service delivery across the health system. Duties include:
Coordinates and supports managed care operations and departmental services, including drafting and tracking patient-specific Letters of Agreement (LOAs) and providing backup for health plan inquiries.Facilitate drafting and production of payer contract amendments and other related documents as part of onboarding process of new affiliated physicians and physician groups. Develops, implements and manages departmental policies and procedures related to payer and specialty contract and compliance monitoring to ensure alignment with internal and external reporting requirements.Completes credentialing and recredentialing applications for health plans covering faculty practice and affiliated entities (e.g., CSMC, MDRH).Collaborates with leadership to drive cross-functional process improvements, enhance communication, and promote collaborative problem-solving. Leads or assists in coordinating the annual AHA hospital services survey responses for areas related to managed care.Manages Requests for Information (RFIs) from health plans and payers for specialty services, reviewing submissions for appropriateness and advancing concerns (e.g., financial or contract-related data) to leadership. Coordinates and communicates RFI deadlines and follow-ups with internal departments and payers to ensure timely responses.Collaborates with transplant program leaders to compile clinical and administrative data for solid organ and bone marrow transplant RFIs and Center of Excellence proposals.Maintain current and accurate compliance documentation (e.g., licensure, insurance, JCAHO) on shared drives to support audits and regulatory readiness.Works with department leadership to develop and manage the annual budget, including data entry into Axiom and liaising with Finance for revisions and analysis. Monitors expenditures and controlling departmental budget, performs account analysis and preparation of monthly variance reports for leadership review.Oversees administrative HR functions including timecard approvals, time-off tracking, new hire orientation, and mandatory training (e.g., C-S Fire and Disaster Plans). Coordinates technical and operational supports needs (e.g., EIS support tickets and requests for tools like DocuSign) to maintain workflow continuity.Leads the creation, development, and ongoing maintenance of a comprehensive payer database to support effective communication and ensure contract compliance. Distributes contract amendments, payer notifications, and provider manual updates to relevant internal collaborators. Develops and maintains databases and tracking tools to monitor RFI status and prepare and submit monthly outcome reports.Qualifications
Requirements:
Bachelor's degree in business administration, finance or another relevant major required.A minimum of 5 years’ experience in managed care, healthcare administration, credentialing, or payer relations, preferably in an academic medical center or integrated health system required.In this role you will demonstrate initiative, resourcefulness and problem- solving skills in organizing and prioritizing work and establishing systems and procedures. The position requires strong customer service and interpersonal skills to effectively work with payers, administration, attorneys and co-workers.Why work here?
Beyond outstanding employee benefits including health and dental insurance, paid vacation, and a 403(b) we take pride in hiring the best, most passionate employees. Our accomplished staff reflects the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation.
Req ID : 11551
Working Title : Managed Care Coordinator
Department : Managed Care and Payor Relations
Business Entity : Cedars-Sinai Medical Center
Job Category : Strategic Plan / Business Dev
Job Specialty : Managed Care
Overtime Status : EXEMPT
Primary Shift : Day
Shift Duration : 8 hour
Base Pay : $38.88 - $60.26