Managed Care Coordinator jobs in Chattanooga, TN

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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RN - Resident Care Coordinator
  • Hamilton Long Term Care
  • Dalton, GA FULL_TIME
  • SUMMARY

    Supervises the day-to-day activities of the nursing assistants and charge nurse/nurse supervisor. Such supervision should be in accordance with current federal, state, and local regulations governing our nursing center, and as may be directed by the Administrator, the Medical Director, and/or the Director of Nursing Services, to provide and maintain appropriate care.


    ATTENDANCE REQUIREMENTS

    Non-exempt Status: May be required to work beyond normal working hours and on weekends and holidays when necessary. Subject to callback during any emergency.


    ACCOUNTABILITY

    Reports to Director of Nursing Services


    PRIDE VALUES

    P-PROFESSIONALISM The expertise, qualities and conduct that characterize a member of a profession"

    R-RESPECT A positive feeling of esteem for a person or other entity

    I-INTEGRITY Honesty and consistency to a set of values

    D-DILIGENE Constant and earnest effort applied to perform a task or accomplish a goal

    E-EXCELLENCE The quality or state of being outstanding or superior


    LICENSURE/CERTIFICATION/EDUCATION REQUIREMENTS

    A RN nursing degree from an accredited college or university as evidenced by primary source of verification preferred. An LPN nursing degree from an accredited college or university as evidenced by primary source of verification required.


    OTHER TRAINING, SKILLS AND EXPERIENCE REQUIREMENTS

    Current RN License in the State of Georgia preferred. Current LPN License in the State of Georgia required. American Heart Association BLS CPR required.


    ESSENTIAL SKILL/KNOWLEDGE FUNCTIONS

    • Operation of oxygen equipment including turning off and on, changing cylinder heads, cleaning/replacing humidifier and others as necessary.
    • Operation of suction machine (oral) including cleaning, selection of appropriate suction catheter and storage.
    • Operation and use of manual respirator.
    • Location and use of emergency equipment supplies (box and/or crash cart etc.).
    • Operation of whirlpool.
    • Operation of scales.
    • Operation of glucose monitoring devices, calibration, and cleaning etc.
    • Use of electronic thermometers (oral/rectal and ear).
    • Delivery of medications (setting up, rotating, charting, ordering, giving to patient etc.).
    • Ordering and use of stock drugs.
    • Administration and documentation of insulin.
    • Use and delivery of PRN medications.
    • Use and delivery of topical treatment application (eye, ear, nose etc.).
    • Use, delivery and documentation of narcotic medication.
    • Knowledge of procedures for receiving drugs from pharmacy.
    • Application of sterile dressings.
    • Operation and proper use of pressure reduction surfaces.
    • Use of oral airway.
    • Knowledge of isolation procedures (when to implement etc.).
    • Knowledge of location and proper use of personal protective equipment (gloves, masks, gowns and aprons etc.).
    • Delivery of enemas (S & S, and fleets).
    • Insertion, irrigation and routine care of male/female catheters.
    • Delivery of tube feedings (insertion, flushing, proper amounts etc.).
    • Knowledge of procedures and ability to determine Advance Directive status for patients.
    • Collection of lab specimens and interpreting results.
    • IV implementation and administration.
    • Seizure precautions and administration of IV medication during a seizure.
    • Knowledge of admissions, discharge and transfer procedures.
    • Documentation and billing of supplies used.
    • Knowledge of procedure for sending patients to the hospital.
    • Knowledge of procedures to follow if unable to reach physician.
    • Make work assignments.
    • Make compliance rounds and report any pertinent issues.
    • Maintain effective lines of communication with attending physicians.
    • Assist the Director of Nursing to coordinate the care planning/MDS process and committee meetings as necessary.
    • Participate in patient screening and selection process as requested.
    • Assist the Director of Nursing to monitor physician services (documentation and visits etc.) in accordance with current regulations.
    • Assist the Director of Nursing in follow-up on consultant recommendations i.e. pharmacy, dietary, etc.).
    • Provide demonstration/education as necessary for CNA to perform job.
    • Maintain knowledge of documentation procedures including appropriate use of forms, timelines, and Medicare documentation etc.


    ESSENTIAL DEPARTMENT MANAGERIAL FUNCTIONS

    • Assess patient care needs and ensure the development of individualized plans of patient care.
    • Assist in evaluating patient care as it is related to individualized patient needs, family involvement, and the physician's plan of care for the patient.
    • May be required to conduct patient care conferences.
    • Assess patient responses to medication and treatment, and make appropriate recommendations for nursing action to be implemented.
    • Provide medications, treatments, diets, rehab and restorative care provided to patients in accordance with physicians orders and the patients individual needs.
    • Required to report problems to the Director of Nursing, conduct daily patient rounds, and initiate corrective action as necessary.
    • May be required to direct and implement nursing service educational programs, quality assurance programs, and infection control programs.
    • Assess equipment and supply needs and make recommendations to Director of Nursing.
    • May be required to direct and supervise scheduling of associates, within established guidelines for allocation of nursing service.
    • May be required to assist in the preparation of written associate performance evaluations.
    • May be required to make management reports and special assignments.
    • Assist the Director of Nursing to plan, develop, organize, and direct departmental functions (including personnel and administrative etc.).
    • Demonstrate appropriate/effective supervisory skills that include fair and uniformly applied corrective actions administered without regard to race, color, creed, national origin, age, sex, religion, handicap, or marital status.
    • Provide to the Director of Nursing appropriate reports/documentation to support departmental updates, corrective actions, and other as necessary.
    • Conduct performance improvement/quality assurance activities as required/requested.
    • Assist the Director of Nursing to maintain appropriate supply and equipment levels in accordance with established departmental budget.
    • Assist as requested, in the interviewing, screening, and selection of associates in accordance with established staffing budgets.
    • Assist the Director of Nursing to maintain appropriate personnel file documentation including reference checks, screenings, corrective actions, evaluations, skills verifications, and others as necessary.
    • Assist the Director of Nursing to maintain staffing patterns in accord with staffing budgets.
    • Review and respond to complaints/grievances (associate and/or patient or family) that concern your department (as requested by the Director of Nursing).
    • Maintain efforts to establish effective interdepartmental communication to provide positive working relationships.
    • Assist the Director of Nursing to monitor departmental associates for compliance with established procedural guidelines and protocols.
    • Maintain appropriate documentation in regards to incident/accidents and OSHA regulations.
    • Assist the Director of Nursing with the preparation of the annual nursing center budget.
    • Comply with established budget restraints.
    • Maintain a working knowledge of current licensure standards and the survey process.
    • Delegate to associates the authority, responsibility and accountability necessary to perform assigned duties.
    • Review departmental functions to provide compliance with current standard/procedural guidelines.
    • Provide hands-on assistance in department functions as necessary.


    ESSENTIAL ADMINISTRATIVE FUNCTIONS

    • Participates in Nursing Center surveys (Licensure/JCAHO) and any subsequently required reports.
    • Attends and participates in continuing educational programs to keep abreast on changes in your field as well as to maintain current licensure/certification, as required.
    • Attends and participates in mandatory in-services.
    • Honors patients rights to fair and equitable treatment, self-administration, individuality, privacy, property and civil rights, including the right to wage complaints.
    • Complies with Corporate Compliance Program.
    • Reports job-related functions/tasks that involve occupational hazards including exposure to blood and body fluids and others as necessary.
    • Follows established safety regulations, to include fire protection/prevention, smoking regulations, infection control, etc.
    • Follows established safety procedures when performing job tasks and/or working with equipment.
    • Performs other related duties as necessary and as directed by supervisor.
    • Complies with all Privacy & Security programs.


    ESSENTIAL GENERAL FUNCTIONS

    • Attendance
    • Punctuality
    • Professional appearance
    • Communicates well with patients and family members providing warm and friendly greeting and an approachable attitude to family/visitors/patients and responds to expressed concerns while displaying a helpful, caring demeanor, answers questions when appropriate in a professional manner.

    PRIMARY ACTIVITY REQUIREMENTS

    Primary Physical Requirements:

    • Lift up to 10 lbs.: Frequently required when lifting charts weighing approximately 5 to 10 pounds.
    • Lift 11 to 25 lbs.: Constantly.
    • Lift 26 to 40 lbs.: Constantly.
    • Lift over 40 lbs.: Constantly.
    • Carry up to 10 lbs.: Occasionally may be required to carry medical charts from one location in facility to another (50 to 100 feet). If carrying more than one chart, can implement the use of a cart.
    • Carry 11 to 25 lbs.: Not required.
    • Carry 26 to 40 lbs.: Not required.
    • Carry over 40 lbs.: Not required.
    • Reach above shoulder height: 4 feet
    • Reach at shoulder height: Constantly required while documenting charts, drawing blood and providing care to patients.
    • Reach below shoulder height: Frequently may be required when reaching for clerical supplies or charting information in drawers.
    • Push/Pull: 20 feet

    Hand Manipulation:

    • Grasping: Constantly during course of day while documenting medical files.
    • Handling: Frequently handling paperwork and occasionally various diagnostic tools such as thermometer, blood pressure gauge, etc.
    • Torquing: Required for opening some medications and tube feedings.
    • Fingering: Occasionally may be required for using computer keyboard and telephone.
    • Controls & Equipment: Computer, various medical equipment, instruments and machines.

    Other Physical Considerations:

    • Twisting: Not required.
    • Bending: Occasionally may occur when drawing blood or taking vital signs.
    • Crawling: Not required.
    • Squatting: Occasionally required.
    • Kneeling: Not required.
    • Crouching: Not required.
    • Climbing: Occasionally.
    • Balancing: Not required.


    During an 8 hour day, Associate is required to:

    Consecutive Hours Total Hours

    Sit 2 4

    Stand 2 4

    Walk 2 2

    Work Surface: Associate may be required to stand on carpeting, linoleum or be seated at a standard desk at the nurses station using an office chair.

    Cognitive and Sensory Requirements:

    • Talking: Necessary for communicating with others.
    • Hearing: Necessary for taking instructions from physicians and supervisor.
    • Sight: Necessary for doing job correctly and effectively.
    • Tasting & Smelling: Smelling is required for accurate maintenance and detection of wounds, urinary tract infection problems, etc.


    EQUIPMENT USED

    Blood pressure gauge, thermometer, stethoscope, hydroxulator, Hoyer lift (hydraulic system), splints, trap, wheelchair, exercise wheel, parallel bars, transfer belt, walkers, canes, free weights, Restor Bikes, suction machine, IV pumps, tube feeding equipment, TENS unit, specialty beds.


    SUMMARY OF OCCUPATIONAL EXPOSURES

    Tasks assigned to this position may involve potential and/or direct exposure to blood, body fluids, infectious disease, air contaminants and hazardous chemicals. May be subject to hostile and emotionally upset patients, family members, associates and visitors.


    OTHER CONSIDERATIONS AND REQUIREMENTS

    The associate must be able to tolerate prolonged sitting as required when documenting information in medical charts for patients. Must be able to direct work in a high-paced nursing center.


    Drug-Free Workplace

  • 25 Days Ago

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Behavioral Health Care Coordinator
  • Camelot Care Centers, LLC of Tennessee
  • Chattanooga, TN FULL_TIME
  • Behavioral Health Care Coordinator Are you searching for a way to use your compassion, knowledge and interpersonal skills? Camelot Care Centers, part of the national Pathways brand of mental health pr...
  • 2 Months Ago

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Staffing Coordinator
  • Care Network
  • Calhoun, GA FULL_TIME
  • This position is responsible for staffing of Certified Nursing Assistants and/or Licensed Nurses. Assists Director of Nursing in staffing appropriately licensed/certified employees through preparation...
  • 1 Month Ago

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Care Coordinator
  • Omni Community Health Inc.
  • Cleveland, TN FULL_TIME
  • Position Title: Care Coordinator I THL Join the OMNI Family Do you want to be a part of a team that improves lives, empowers people, and strengthens communities? Want to be a thought leader and change...
  • 20 Days Ago

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Care Coordinator
  • Isaiah 117 House
  • Cleveland, TN PART_TIME
  • Overview:Care Coordinator: Part-Time A person will be successful in this position if they love caring for others and have the ability to nurture and support while inviting others into the ministry. On...
  • Just Posted

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Care Coordinator
  • Blakeford Senior Living Community
  • Monteagle, TN PART_TIME
  • JOIN OUR LIVE WELL BY BLAKEFORD TEAM IN MONTEAGLE/SEWANEE Bring your passion for seniors to Blakeford Senior Living. We are searching for a caring and compassionate individual that has a heart for sen...
  • 12 Days Ago

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0 Managed Care Coordinator jobs found in Chattanooga, TN area

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Care Coordinator LPN / CMA - Full Time (62736)
  • Hamilton Health Care System
  • Dalton, GA
  • JOB SUMMARY The Care Coordinator/ Wellness Nurse integrates care and services with an emphasis on preventative care and ...
  • 4/23/2024 12:00:00 AM

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Medical Device Sales
  • American Hearing Care
  • Fort Oglethorpe, GA
  • Job Description Job Description Our Mission - To help MORE people hear better through outstanding patient care and award...
  • 4/23/2024 12:00:00 AM

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Care Coordinator LPN - HPG Convenient Care Murray (59853)
  • Hamilton Health Care System
  • Dalton, GA
  • JOB SUMMARY The Care Coordinator Nurse integrates care and services with an emphasis on preventative care and education....
  • 4/22/2024 12:00:00 AM

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Unit Care Coordinator (Licensed Practical Nurse/LPN) $3,500.00 Sign-on Bonus - Agency free facility
  • Life Care Center of Red Bank
  • Chattanooga, TN
  • Position Details Employment Status: Full-Time Shift: Day Shift Position Summary The LPN Unit Care Coordinator is respons...
  • 4/22/2024 12:00:00 AM

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LPN, Home Health Full Time
  • CenterWell Home Health
  • Chattanooga, TN
  • Become a part of our caring community and help us put health first Primary territory - Bradley, Polk, McMinn, Meigs, Rhe...
  • 4/21/2024 12:00:00 AM

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Bilingual Patient Care Coordinator
  • Medical Personnel Services
  • Chattanooga, TN
  • Job Description Job Description Patient Care Coordinators work as patient advocates. They generally assist patients who ...
  • 4/20/2024 12:00:00 AM

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Case Manager / Counselor - (Bachelor's) Hamilton & McMinn
  • Helen Ross McNabb Center
  • Chattanooga, TN
  • Case Manager / Counselor - (Bachelor's) Hamilton & McMinn We'vebeen waiting for someone like you! With a wide range of a...
  • 4/20/2024 12:00:00 AM

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LPN Private Duty
  • SunCrest Home Health - Manchester PD
  • Jasper, TN
  • We are hiring for a Full Time Private Duty LPN's in the Jasper area. Case Specific, Enhanced Pay Rates are available wit...
  • 2/29/2024 12:00:00 AM

According to the United States Census Bureau, the city has a total area of 144.6 square miles (374.4 km2), of which 137.1 square miles (355.2 km2) are land and 7.4 square miles (19.2 km2), or 5.12%, are water. The most prominent natural features in and around Chattanooga are the Tennessee River and the surrounding mountains. The city is nestled between the southwestern Ridge-and-valley Appalachians and the foot of Walden's Ridge; the river separates the ridge from the western side of downtown. Several miles east, the city is bisected by Missionary Ridge. The Tennessee River is impounded by th...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$44,778 to $76,845
Chattanooga, Tennessee area prices
were up 1.3% from a year ago

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