Managed Care Coordinator

Description Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well‑being of the unique communities we serve. UNC Health is hiring a full‑time Managed Care Coordinator to join our team! Our ideal candidate will have: Epic Hospital Billing or Professional Billing Expected Reimbursement Contracts Administration certification or similar proficiency in other vendor software. Overall general understanding of Healthcare Revenue Cycle processes. Epic Hospital Billing Experience or similar in other vendor software. Specifics as follows: Resolving insurance payment variances. Understanding of insurance payer reimbursement terms and billing to support. Strong understanding of insurance payment process/posting of payer remittance information. Summary The Managed Care Coordinator is a key member of the Contract Administration team. This role is responsible for maintaining accurate reimbursement calculations, performing payment variance analysis, supporting ad hoc reporting needs, and assisting with contract modeling and negotiation activities. The position plays an important role in ensuring payer contracts are accurately reflected in billing systems and that financial outcomes align with contractual expectations. Responsibilities Billing Reimbursement Configuration and Maintenance Build, maintain, and troubleshoot expected Hospital, ASC, and Ancillary reimbursement calculations within Epic for both governmental and commercial payers. This includes ensuring that reimbursement logic is accurately loaded and aligned between Epic and payer systems. Responsibilities include implementing routine updates such as quarterly drug fee schedules, annual payer rate increases, and annual fee schedule updates. Technical capabilities include building contracts in the Epic POC environment and utilizing Content Manager for data couriering to PRD. The role requires obtaining the Epic RHB390 Hospital Billing Expected Reimbursement Contracts certification within the first 90 days. Contract Modeling and Negotiation Support Support major payer negotiations by developing and analyzing contract modeling scenarios. Using Managed Care–developed tools, proposed commercial payer rates are modeled across all UNC Health entities to assess expected financial impact. Results are summarized and presented to financial and operational leadership to support data‑driven decision‑making. Contract Validation and Variance Analysis Validate contract builds by performing payment variance analysis to ensure contracted reimbursement terms are correctly implemented and functioning as expected. Identify discrepancies and collaborate with internal teams to resolve issues. Education and Experience Education Requirements: Bachelor’s degree in relevant field. Professional Experience Requirements: If Bachelor’s degree: requires two (2) years of experience with managed care contracts and provider relations. If Associate’s degree: requires six (6) years of experience with managed care contracts and provider relations. If High School diploma or GED: requires ten (10) years of experience with managed care contracts and provider relations. If Master’s degree: requires zero (0) years of experience. Licensure/Certification Requirements: No licensure or certification required. Equal Opportunity Statement Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation. UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email View email address on click.appcast.io if you need a reasonable accommodation to search and/or to apply for a career opportunity. #J-18808-Ljbffr