Managed Care Coordinator jobs in Costa Mesa, 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
  • Irvine, 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.
  • 8 Days Ago

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Care Coordinator, LVN Home Health
  • Care Plus Nursing Services, Inc.
  • Laguna Hills, CA FULL_TIME
  • Job Title/Position: Care Coordinator (LVN/LPN) Reports to: Operation Director/DPCS Job Description Summary: Responsible for coordinating home care services for patients, which includes establishing an...
  • 14 Days Ago

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Care Coordinator
  • CareConnectMD, Inc
  • Costa Mesa, CA FULL_TIME
  • Overview Key Duties and Responsibilities Provides support to the Case Manager and Care Navigator in coordination of patient care. Tracks utilization management activities to include updating informati...
  • 20 Days Ago

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Care Coordinator
  • Healthy At Home Caregivers
  • Point, CA FULL_TIME
  • DescriptionAnswer potential client inquiries, perform in home assessments and conduct home visits to existing clients to ensure excellent care is provided and needs are met.Responsible for creating an...
  • 1 Day Ago

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Care Coordinator
  • NEW DIRECTIONS FOR WOMEN
  • Costa Mesa, CA PART_TIME,FULL_TIME
  • Schedule: 11:00pm-7:30am Thursday, Friday, Saturday, Sunday, Monday Essential Duties: Responsible for tracking attendance in groups. Responsible for charting groups/activities not facilitated by clini...
  • 8 Days Ago

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Care Coordinator
  • NEW DIRECTIONS FOR WOMEN INC
  • COASTA MESA, CA OTHER
  • Job Details Job Location: COASTA MESA, CA Position Type: Full-Time/Part-Time Salary Range: Undisclosed DescriptionKey Areas of Responsibility: Clinical and Groups: Responsible for tracking attendance ...
  • 26 Days Ago

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0 Managed Care Coordinator jobs found in Costa Mesa, CA area

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Care Coordinator
  • Premium Health
  • Irvine, CA
  • Job Description Job Description Due to the large volume of applicants for this job, we prefer to get a video along with ...
  • 3/29/2024 12:00:00 AM

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Care Coordinator
  • Pac Ventures Llc
  • Valencia, CA
  • Job Description Job Description Benefits/Perks Flexible Scheduling Competitive Compensation Careers Advancement Job Summ...
  • 3/29/2024 12:00:00 AM

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Care Coordinator
  • Interim Healthcare of Irvine
  • Irvine, CA
  • Job Description Job Description We are seeking an in-office Care Coordinator plus Recruiter to join our Interim HealthCa...
  • 3/28/2024 12:00:00 AM

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Care Coordinator
  • Center for Family Health and Education
  • Los Angeles, CA
  • Job Description Job Description We are seeking a Care Coordinator to become a part of our team! You will coordinate medi...
  • 3/27/2024 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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Case Manager (Care Coordinator)
  • Pacifica Hospital of the Valley
  • Los Angeles, CA
  • Job Description Job Description CARE COORDINTOR (CASE MANAGER) BEHAVIORAL HEALTH URGENT CARE CENTER (OUTPATIENT CLINIC) ...
  • 3/26/2024 12:00:00 AM

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Case Manager (Care Coordinator)
  • Pacifica Hospital of the Valley
  • Los Angeles, CA
  • Job Description Job Description CARE COORDINTOR (CASE MANAGER) BEHAVIORAL HEALTH URGENT CARE CENTER (OUTPATIENT CLINIC) ...
  • 3/25/2024 12:00:00 AM

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Care Coordinator
  • Partners in Care Foundation
  • Los Angeles, CA
  • Job Description Job Description Qualifications: Pay range $19-22 per hour. In person client visits. Experience: · Two ye...
  • 3/25/2024 12:00:00 AM

Costa Mesa (/ˌkoʊstə ˈmeɪsə/) is a city in Orange County, California. Since its incorporation in 1953, the city has grown from a semi-rural farming community of 16,840 to a primarily suburban and edge city with an economy based on retail, commerce, and light manufacturing. The population was 109,960 at the 2010 United States Census. Costa Mesa is located 37 miles (60 km) southeast of Los Angeles, California, 88 miles (142 km) north of San Diego, California and 425 miles (684 km) south of San Francisco, Costa Mesa encompasses a total of 16 square miles (41 km2) with its southernmost border only...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$55,318 to $94,938
Costa Mesa, California area prices
were up 3.0% 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