Managed Care Coordinator jobs in Bakersfield, CA

Managed Care Coordinator coordinates utilization reviews of managed care contracts using established guidelines and processes. Ensures all clinical operations comply with Medicare and Medicaid guidelines and other managed care policies. Being a Managed Care Coordinator communicates with physicians, discharge planners and others to process referrals, authorization for services, and capture data related to utilization. Maintains managed care contracts and information databases and prepares reports. Additionally, Managed Care Coordinator typically requires an associate degree in nursing. Typically reports to a supervisor or manager. Typically requires Registered Nurse (RN). The Managed Care Coordinator has gained full proficiency in a broad range of activities related to the job. Independently performs a wide range of complex duties under general guidance from supervisors. To be a Managed Care Coordinator typically requires 5-7 years of related experience. (Copyright 2024 Salary.com)

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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Bakersfield, CA FULL_TIME
  • We are currently seeking a skilled and motivated Pharmacist with expertise in Pharmacy Benefit Management (PBM) and Managed Care. In this pivotal role, you will be responsible for overseeing medication utilization, formulary management, and ensuring cost-effective pharmacy services. The ideal candidate will bring a deep understanding of managed care principles, a proactive approach to problem-solving, and a commitment to optimizing pharmacy outcomes within a managed care environment.

    Preferred Qualifications:
    PharmD degree from an accredited pharmacy program
    Previous experience in Pharmacy Benefit Management (PBM) or Managed Care
    Knowledge of formulary development and management
    State pharmacy license in good standing
    Strong analytical and data interpretation skills
    Excellent communication and negotiation abilities
    Familiarity with healthcare regulations and compliance standards
    Collaboration experience with healthcare providers, payers, and pharmaceutical manufacturers
    Proficiency in utilizing pharmacy management software and tools
    Active participation in relevant professional organizations
    Dedication to staying informed about industry trends and innovations

    Responsibilities:
    Collaborate with healthcare stakeholders to implement and optimize pharmacy benefit programs
    Conduct formulary reviews and assessments to ensure cost-effective and evidence-based medication choices
    Monitor and analyze pharmacy utilization trends, identifying opportunities for cost savings and improved patient outcomes
    Provide expertise in drug utilization management and prior authorization processes
    Stay informed about industry regulations, guidelines, and emerging trends in managed care pharmacy
    If you are a passionate and experienced pharmacist with a background in PBM or Managed Care, we invite you to join our dynamic team dedicated to advancing healthcare through innovative and cost-effective pharmacy solutions. Apply now to contribute to the future of managed care pharmacy.
  • 30 Days Ago

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CCT/CCA Care Coordinator
  • Access TLC Health Care
  • Bakersfield, CA FULL_TIME
  • Access TLC is seeking dedicated and compassionate Care Coordinators to join our team. The Care Coordinator has direct responsibility for an assigned caseload of patients and provides case management a...
  • 1 Month Ago

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MDS Coordinator (RN/LVN)
  • Sweetwater Care
  • Porterville, CA FULL_TIME
  • POSITION DESCRIPTION: Responsible for timely and accurate completion of both the RAI process and care management process from admission to discharge in accordance with company policy and procedures, a...
  • 12 Days Ago

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REMOTE MDS COORDINATOR (RN/LVN)
  • Sweetwater Care
  • Delano, CA FULL_TIME
  • POSITION DESCRIPTION: Responsible for timely and accurate completion of both the RAI process and care management process from admission to discharge in accordance with company policy and procedures, a...
  • 11 Days Ago

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Enhanced Care Management Care Coordinator
  • OMNI FAMILY HEALTH
  • Bakersfield, CA FULL_TIME
  • Title: Enhanced Care Management Care Coordinator Job Summary: This position is responsible for assigned social work case management functions for Omni Family Health (OFH). The primary duty of the Enha...
  • 20 Days Ago

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MDS COORDINATOR (RN/LVN) CONTRACT POSITION
  • Sweetwater Care
  • Delano, CA FULL_TIME
  • POSITION DESCRIPTION: Responsible for timely and accurate completion of both the RAI process and care management process from admission to discharge in accordance with company policy and procedures, a...
  • 8 Days Ago

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0 Managed Care Coordinator jobs found in Bakersfield, CA area

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Nurse Case Manager
  • Rehabilitation Care Coordination
  • Bakersfield, CA
  • Job Description Job Description What do our Nurse Case Managers do? A Nurse Case Manager is an advocate for the welfare ...
  • 4/20/2024 12:00:00 AM

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Travel Nurse RN - Case Management - $3,316 per week
  • Hiring Now!
  • Bakersfield, CA
  • PHP is seeking a travel nurse RN Case Management for a travel nursing job in Bakersfield, California. Job Description & ...
  • 4/20/2024 12:00:00 AM

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RN, Care Manager, Care Management, Part-Time, Days
  • Adventist Health
  • Bakersfield, CA
  • Job Description Central to all that California has to offer, Adventist Health Bakersfield has been providing an extraord...
  • 4/20/2024 12:00:00 AM

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President Mercy Hospital of Bakersfield
  • CommonSpirit Health
  • Bakersfield, CA
  • Overview CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With m...
  • 4/20/2024 12:00:00 AM

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Ultrasound Technologist, Quest Diagnostic, Per Diem
  • Adventist Health
  • Bakersfield, CA
  • Job Description Central to all that California has to offer, Adventist Health Bakersfield has been providing an extraord...
  • 4/20/2024 12:00:00 AM

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Behavioral Health Therapist (ASW/MSW/AMFT)- Wilson Children's
  • Clinica Sierra Vista
  • Bakersfield, CA
  • Clinica Sierra Vista is excited to be one of the largest Federally Qualified Health Centers in the Nation! We're honored...
  • 4/20/2024 12:00:00 AM

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Caregiver for Outings and Activities
  • Sevita
  • Bakersfield, CA
  • Please note: This role requires proof of COVID-19 vaccination for eligibility. Are you motivated by relationships and yo...
  • 4/18/2024 12:00:00 AM

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RN Case Manager $72/hr-$77/hr
  • Atc Healthcare
  • Bakersfield, CA
  • Job Description ATC HEALTHCARE IS CURRENTLY HIRING FOR A REGISTERED NURSE - CASE MANAGEMENT ASSIGNMENT FOR A PROMINENT H...
  • 4/16/2024 12:00:00 AM

Bakersfield is a city in and the county seat of Kern County, California, United States. It covers about 151 sq mi (390 km2) near the southern end of the San Joaquin Valley and the Central Valley region. Bakersfield's population is around 380,000, making it the 9th-most populous city in California and the 52nd-most populous city in the nation. The Bakersfield–Delano Metropolitan Statistical Area, which includes all of Kern County, had a 2010 census population of 839,631, making it the 62nd-largest metropolitan area in the United States. The more built-up urban area that includes Bakersfield and...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$52,265 to $89,695
Bakersfield, California area prices
were up 2.5% from a year ago

Managed Care Coordinator in San Francisco, CA
Care managers also sometimes provide case management--for example, information about transportation assistance, food programs, and other social services.
December 12, 2019
Managed Care Coordinator in Santa Barbara, CA
Nursing home administrators manage staff, admissions, finances, and care of the building, as well as care of the residents in nursing homes.
February 02, 2020
Managed Care Coordinator in Orange, CA
Assist with on-boarding and training of new Managed Care Coordinators.
January 20, 2020