Managed Care Coordinator jobs in Huntington Beach, 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.
  • 1 Month Ago

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Managed Care Biller - Centralized Billing Office (CBO)
  • Pursue Health LLC
  • Irvine, CA FULL_TIME
  • Pursue Health, LLC is a rapidly growing company that provides a full spectrum of healthcare consulting and support services to Skilled Nursing Facilities, Hospice Agencies, Out Patient Rehabilitation ...
  • 10 Days Ago

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Managed Care Pharmacist 5 - Population Health - P/T Days
  • University of California - Irvine Health
  • Orange, CA FULL_TIME
  • Updated: Apr 21, 2024 Location: Orange Job Type: Department: Population Health UC Title: PHARMACIST 5Position Number: 41083769Reports to: Admin Director Pop Hlth MgmtWorking Title: Managed Care Pharma...
  • 2 Days Ago

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Care Coordinator
  • Interim HealthCare - Irvine, CA
  • Irvine, CA PART_TIME
  • We are seeking an in-office Care Coordinator plus Recruiter to join our Interim HealthCare of Irvine team!As a Care Coordinator, you will be responsible for coordinating and scheduling the shifts with...
  • 25 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...
  • 28 Days Ago

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Workers Compensation Coordinator-MA
  • Newport Urgent Care
  • Newport, CA FULL_TIME
  • We are searching for an experienced medical assistant with strong organizational skills, to join our urgent care in Newport Beach. This will be a Full-Time position. Coordinate the management of worke...
  • Just Posted

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0 Managed Care Coordinator jobs found in Huntington Beach, CA area

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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...
  • 4/24/2024 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) ...
  • 4/24/2024 12:00:00 AM

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Patient Care Coordinator
  • Back2 Health Physical Therapy Inc
  • Los Angeles, CA
  • Job Description Job Description Back 2 Health Physical Therapy is looking for a highly organized and outgoing individual...
  • 4/24/2024 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...
  • 4/23/2024 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...
  • 4/22/2024 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...
  • 4/21/2024 12:00:00 AM

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Care Coordinator
  • Eisner Health
  • Los Angeles, CA
  • *This position requires travel within the San Fernando Valley* Position: Lead Care Manager Who we are: We are a non-prof...
  • 4/20/2024 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) ...
  • 4/20/2024 12:00:00 AM

Huntington Beach is a seaside city in Orange County in Southern California. The city is named after American businessman Henry E. Huntington. The population was 189,992 during the 2010 census, making it the most populous beach city in Orange County and the seventh most populous city in the Los Angeles-Long Beach-Anaheim, CA Metropolitan Statistical Area.[citation needed] Its estimated 2014 population was 200,809. It is bordered by Bolsa Chica Basin State Marine Conservation Area on the west, the Pacific Ocean on the southwest, by Seal Beach on the northwest, by Westminster on the north, by Fou...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$54,482 to $93,499
Huntington Beach, 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