Managed Care Coordinator jobs in Nebraska

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
  • Omaha, NE 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.
  • 27 Days Ago

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Client Care Coordinator
  • Comfort Keepers Home Care
  • Omaha, NE FULL_TIME
  • Do you have a positive attitude and enjoy working with people? Are you looking for a company that can offer a fulfilling and rewarding career? At Comfort Keepers we provide one-on-one care to seniors ...
  • 6 Days Ago

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Patient Care Coordinator
  • Eye Care Specialties-Pine Lake
  • Lincoln, NE FULL_TIME
  • Patient Care Coordinators are responsible for providing exceptional service by welcoming our patients and ensuring all check-in and checkout processes are completed. Duties and Responsibilities Acknow...
  • 28 Days Ago

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Long Term Care Coordinator I
  • Iowa Total Care
  • Omaha, NE FULL_TIME
  • You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offeri...
  • 22 Days Ago

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Staffing Coordinator
  • Care Network
  • Gretna, NE FULL_TIME,PART_TIME
  • Duties will include coordinating staff for nursing, as needed throughout the facility. This includes receiving and promptly acting on request for staff coverage from supervisors on a daily basis . Thi...
  • 1 Month Ago

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Scheduling Coordinator
  • Care Network
  • North Platte, NE FULL_TIME
  • The Maples At Centennial Park has amazing things happening every day! Do you want to be part of a team that is passionate about providing compassion and quality care for each of our residents? We curr...
  • 20 Days Ago

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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) ...
  • 4/15/2024 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...
  • 4/15/2024 12:00:00 AM

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RN - Registered Nurse Case Manager - Care Coordination
  • Geisinger
  • Zion Grove, PA
  • Job Title: RN - Registered Nurse Case Manager - Care Coordination Location: Danville, Pennsylvania Job Category: RN - Re...
  • 4/15/2024 12:00:00 AM

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RN - Registered Nurse Case Manager - Care Coordination
  • Geisinger
  • Nuremberg, PA
  • Job Title: RN - Registered Nurse Case Manager - Care Coordination Location: Danville, Pennsylvania Job Category: RN - Re...
  • 4/15/2024 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) ...
  • 4/14/2024 12:00:00 AM

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Case Manager/Care Coordination Consultant
  • Boys Town
  • West Palm Beach, FL
  • Provides intensive and professional case management services to youth utilizing a strength based and comprehensive model...
  • 4/14/2024 12:00:00 AM

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Managed Care Coordinator - Referral Specialist
  • TalentBurst, Inc.
  • Boston, MA
  • Specialty: Referral Specialist Duration: 13 Weeks Shift Group: 8H Day REQUISITION COMMENTS AND NOTES •Work collaborative...
  • 4/14/2024 12:00:00 AM

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office manager/ care coordinator
  • 5 Stars Home Care LLC
  • Alexandria, VA
  • Job Description Job Description Job Summary: Duties: Responsible for all areas of Operations; human resources, intakes, ...
  • 4/13/2024 12:00:00 AM

The state is bordered by South Dakota to the north; Iowa to the east and Missouri to the southeast, across the Missouri River; Kansas to the south; Colorado to the southwest; and Wyoming to the west. The state has 93 counties and is split between two time zones, with the state's eastern half observing Central Time and the western half observing Mountain Time. Three rivers cross the state from west to east. The Platte River, formed by the confluence of the North Platte and the South Platte, runs through the state's central portion, the Niobrara River flows through the northern part, and the Rep...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$46,403 to $79,635

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