Managed Care Coordinator jobs in California

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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Contract Coordinator, Managed Care
  • Community Medical Centers of Fresno, CA
  • Fresno, CA OTHER
  • Overview

    *All positions are located in Fresno/Clovis CA*

     

    Opportunities for you!

    • Join a Forbes Top 10 CA Employer!
    • Direct impact on quality patient care.
    • Free Continuing Education and certification including BLS, ACLS and PALS
    • Tuition reimbursement, education programs, and scholarships
    • Vacation time starts building on Day 1, and builds with your seniority
    • 403(b) retirement plan with up to 8% matching contributions 
    • Free parking and electric charging
    • Great food options with on-demand ordering

     

    Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community.

    We know that our ability to provide the highest level of care begins with taking care of our incredible teams. Want to learn more? Click here. 

    Responsibilities

    Provide assistance to the Director of Managed Care. Supports, at various levels of responsibility, activities related to the contracting and contract management process for facility, physician, ancillary and CMC health plan contracts. Responsible for contract administration activities, including facilitating and ensuring contract compliance, developing and maintaining contract detail reports, provider databases and demographic information. Responsible for physician contract files including development of contracts and addendums, correspondence and maintenance. Coordinates contract implementation and resolution of contractual issues with payors, facilities, physicians and internal operational staff.

    Qualifications

    Minimum required:

    • Associates degree in Business or Healthcare Administration and 3 years experience in medical office management/billing, insurance or managed care environments. Five years relevant experience may be substituted in lieu of education and experience.

    Preferred:

    • Bachelors degree in Business or Healthcare Administration and four years experience in medical practice, insurance or managed care environments.

    Disclaimers

    • Pay ranges listed are an estimate and subject to change.• If any bonuses are noted, they are only applicable to external hires meeting criteria.

  • 25 Days Ago

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Managed Care Enrollment Coordinator
  • Arroyo Vista Family Health Center
  • Los Angeles, CA FULL_TIME
  • Salary Range: $21.22 - $23.90 Hourly *Summary:*Under the direct supervision of the Director of Managed Care Services, the Managed Care Enrollment Coordinator is responsible for coordinating and implem...
  • 8 Days Ago

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Contract Coordinator, Managed Care
  • Community Health System - CA
  • Fresno, CA FULL_TIME
  • Overview: All positions are located in Fresno/Clovis CA * Opportunities for you! Join a Forbes Top 10 CA Employer! Direct impact on quality patient care. Free Continuing Education and certification in...
  • 18 Days Ago

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Warehouse Coordinator
  • Managed Mobile
  • Anaheim, CA FULL_TIME
  • The Warehouse Coordinator is responsible for managing and maintaining all warehouse operations and all logistical functions for Placentia, Commerce, San Diego and Chino. Will be the main point of cont...
  • 10 Days Ago

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Parts Coordinator - Mobile Fleet
  • Managed Mobile
  • Anaheim, CA FULL_TIME
  • Managed Mobile, Inc. is the market leader for commercial fleet maintenance in California and Nevada. Our core focus is developing great people, delivering a great client experience, and building a gre...
  • 1 Month Ago

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Parts Coordinator - Mobile Fleet
  • Managed Mobile
  • CA, CA FULL_TIME
  • Managed Mobile, Inc. is the market leader for commercial fleet maintenance in California and Nevada. Our core focus is developing great people, delivering a great client experience, and building a gre...
  • 1 Month Ago

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Managed Care Coordinator - Referrals
  • Beth Israel Lahey Health
  • Boston, MA
  • When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. Job Typ...
  • 3/28/2024 12:00:00 AM

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Managed Care Coordinator
  • Elevance Health
  • Roanoke, VA
  • Anticipated End Date: 2024-04-22 Position Title: Managed Care Coordinator Job Description: Managed Care Coordinator MUST...
  • 3/27/2024 12:00:00 AM

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Managed Care Coordinator
  • MJHS Health System
  • New York, NY
  • Req #: 1509 Job ID: 13084 Job Location(s): New York, NY Zip Code: 10040 Category: Office and Administrative Support Agen...
  • 3/26/2024 12:00:00 AM

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Manager, Care Coordination
  • SCAN
  • Long Beach, CA
  • About SCAN SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adult...
  • 3/26/2024 12:00:00 AM

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Manager-Care Coordination
  • St. Catherine of Siena
  • Rockville Centre, NY
  • Overview Manager, Care Coordination (RN), Rockville Centre, NY Explore a career with Mercy Hospital, a 375-bed not-for-p...
  • 3/26/2024 12:00:00 AM

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Manager Care Coordination
  • Crouse Hospital
  • Syracuse, NY
  • Care Coordination is a collaborative practice model including the multidisciplinary health care team, the patient and fa...
  • 3/24/2024 12:00:00 AM

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Manager Care Coordination
  • Catholic Health Services
  • West Islip, NY
  • Overview Manager of Care Coordination (MCC) - Registered Nurse (RN) Are you exceedingly driven, dedicated, and passionat...
  • 3/24/2024 12:00:00 AM

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Manager Care Coordination
  • St. Catherine of Siena
  • West Islip, NY
  • Overview Manager of Care Coordination (MCC) - Registered Nurse (RN) Are you exceedingly driven, dedicated, and passionat...
  • 3/24/2024 12:00:00 AM

California is a state in the Pacific Region of the United States. With 39.6 million residents, California is the most populous U.S. state and the third-largest by area. The state capital is Sacramento. The Greater Los Angeles Area and the San Francisco Bay Area are the nation's second and fifth most populous urban regions, with 18.7 million and 9.7 million residents respectively. Los Angeles is California's most populous city, and the country's second most populous, after New York City. California also has the nation's most populous county, Los Angeles County, and its largest county by area, S...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$54,723 to $93,916

Managed Care Coordinator in New Orleans, LA
Health systems must meet the operational challenge of managing provider data for thousands of participating providers in their value-based care networks.
January 11, 2020
Managed Care Coordinator in Gainesville, FL
Many telehealth programs give patients easy access to any additional educational materials provided by their health plan or primary care provider.
December 23, 2019
Managed Care Coordinator in Houston, TX
Works with relevant parties to ensure deliverable from all parties are achieved in accordance with strategic timelines.Maintains CHSLI master list of service locations (facility, professional and continuing care)Assists in the resolution of referral, authorization and claims payment issuesSupports Directors in effort to educate and assist Hospital departments in meeting internal and MCO operational requirements.
December 27, 2019