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)
At Johns Hopkins All Children's Hospital we offer an excellent Benefits Package, to include:
Managed Care Analyst Position Summary:
The Managed Care Analyst is responsible for all loading, modeling, support, and maintenance of the managed care contracts and fee schedules within the contract management system. This includes contracts for all Health Systems entities; facility, professional, home care, infusion, pharmacy, etc. Provides key support for the implentation of new and upgraded systems/releases or new/revised operational procedures. Is capability to model, support and operationalize risk-based contracting methodologies and global transplant agreements is also necessary.
Managed Care Analyst Key Accountabilities:
Work Hours: 8am - 4:40pm
Work Location: Remote
(must reside in Maryland, Virginia, Washington DC, Pennsylvania, Florida or Delaware)
Managed Care Analyst Qualifications:
We are committed to providing a healthy and safe environment for our patients, visitors and staff members. The Johns Hopkins Hospital has a tobacco-free at work policy. Employees must refrain from using any tobacco products during their work shifts — including while at lunch or on breaks, and whether they are on or off campus.
Clear All
0 Managed Care Coordinator jobs found in Saint Petersburg, FL area