Managed Care Coordinator jobs in Escondido, 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
  • San Diego, 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.
  • 7 Days Ago

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Data Management Specialist
  • Southern California Physicians Managed Care...
  • San Diego, CA FULL_TIME
  • Department: Information Technology Level: Non-Supervisory Reports To: Directory of Information Technology and Security Private Health Information (PHI): Position has complete access to electronic PHI....
  • 1 Day Ago

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Provider/Benefit Data Support Specialist
  • Southern California Physicians Managed Care...
  • San Diego, CA FULL_TIME
  • Department: Finance Level: Non-supervisory Reports To: Manager Revenue Recovery & Reimbursement Private Health Information (PHI): Position requires read/write access to providers and fee schedules. Re...
  • 1 Month Ago

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Data Management Specialist
  • Southern California Physicians Managed Care Services
  • San Diego, CA FULL_TIME
  • Position Title: Data Management Specialist Department: Information Technology Level: Exempt, Non-Supervisory Reports To: Directory of Information Technology and Security Position's Access to Private H...
  • 2 Months Ago

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Sr Managed Care Biller/Collector - Patient Accounting
  • Paradise Valley Hospital
  • National, CA FULL_TIME
  • Overview Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Paradise Valley Hospital, a member of Prime Healthcare, offers incredi...
  • 23 Days Ago

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Inclusive Care Coordinator
  • Kid Care
  • Carlsbad, CA FULL_TIME
  • We have full-time opportunities available to be a part of a very fulfilling position on our respite team! You have the opportunity to make a difference in the lives of children and teens who have spec...
  • 1 Month Ago

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0 Managed Care Coordinator jobs found in Escondido, CA area

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New Patient Care Coordinator
  • Fertility Institute of San Diego
  • San Diego, CA
  • Job Description Job Description New Patient Care Coordinator JOIN OUR GROWING TEAM! Fertility Institute of San Diego is ...
  • 3/27/2024 12:00:00 AM

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Associate Patient Care Coordinator
  • Optum
  • Oceanside, CA
  • Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. ...
  • 3/26/2024 12:00:00 AM

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Donor Care Coordinator
  • San Diego Rescue Mission
  • San Diego, CA
  • At the San Diego Rescue Mission, we are driven by a profound belief in compassion, service, and the transformative power...
  • 3/25/2024 12:00:00 AM

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Customer Care Coordinator
  • Numotion
  • San Diego, CA
  • Customer Care Coordinator Tracking Code 7736-128 Job Description By joining Numotion, you will be a part of the nations ...
  • 3/25/2024 12:00:00 AM

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Patient Care Coordinator
  • Optum
  • San Clemente, CA
  • Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. ...
  • 3/25/2024 12:00:00 AM

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Associate Patient Care Coordinator
  • Optum
  • Vista, CA
  • Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. ...
  • 3/25/2024 12:00:00 AM

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Patient Care Coordinator
  • La Maestra Community Health Centers
  • El Cajon, CA
  • Job Description Job Description Summary: The Patient Care Coordinator is responsible for the timely processing, scheduli...
  • 3/24/2024 12:00:00 AM

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Medical Receptionist | Patient Care Coordinator
  • Retina Consultants San Diego
  • San Diego, CA
  • Job Description Job Description About RCSD Retina Consultants San Diego is the oldest and most prestigious Retina practi...
  • 3/24/2024 12:00:00 AM

According to the United States Census Bureau, the city has a total area of 37.0 square miles (96 km2). 36.8 square miles (95 km2) of it is land and 0.2 square miles (0.52 km2) of it is water. The total area is 0.48% water. The city is growing at a rapid rate with new communities like Hidden Trails appearing at the east end of East Valley Parkway. The city proper is surrounded by several sparsely populated unincorporated communities. These include Jesmond Dene and Hidden Meadows to the north; Felicita Park to the southwest; and Rincon Del Diablo to the southeast. Residents of these communities...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$53,243 to $91,375
Escondido, California area prices
were up 2.6% 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