Managed Care Coordinator jobs in Salina, KS
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)
Recently Added Managed Care Coordinator jobs
Credentialing and Managed Care Coordinator
- The US Oncology Network
-
Wichita, KS
OTHER
-
Overview:
At the Cancer Center of Kansas, we value each and every employee for their life-saving expertise and the role they play in making our patients' lives as easy and comfortable as possible. Our employees are our most valuable resource. They help us create the warm and caring environment that's the foundation for some of the best cancer research and care in the country. If you would like to join a team dedicated to improving lives every day, contact us below.
Responsibilities:
SCOPE: Under general supervision, applies credentialing knowledge to efficiently coordinate provider credentialing, licensure and hospital privileges activities. Assists in administrative activities to support state/practice managed care functions, which may include provider plan participation and credentialing, contract files, explanation of benefits (EOB) analysis and managed care reporting. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards.
ESSENTIAL DUTIES AND RESPONSIBILITIES:- Credentials and re-credentials providers according to quality standards and company policies and procedures. Notifies providers of licensure expirations and submits licensure applications and renewal forms with payment to State agencies and appropriate departments. Recommends process improvements.
- Maintains current provider licensure files and provides information to hospitals and other healthcare providers as appropriate. Requests and completes hospital credentialing and privileges applications for providers.
- Obtains and maintains provider participation in managed care plans in a timely manner and communicates information to practice sites and business office.
- May implement and maintain the contract management system to include terms of the contract, providers credentialed to the payor and other contracted service providers (labs, hospitals).
- May complete EOB analyses or fee schedule variance reporting on a monthly basis for the top Managed Care payors according to policy and procedure. May produce monthly managed care reports and implement new analysis tools to assist in reporting functions.
- May maintain expected reimbursement by CPT code for the top payor contracts in each market and communicate changes to system librarian.
- May develop and provide maintenance of proformas for all contracts.
- Supports Network Contracting Representative/Manager in general administrative functions.
- Trains junior and practice staff with respect to managed care contracts, policies and procedures.
- Other duties as requested or assigned.
MINIMUM QUALIFICATIONS:
High school diploma or equivalent required. Associates Degree preferred. At least three (3) years physician credentialing and/or managed care support experience required.
COMPETENCIES:- Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; is regarded a san expert in the technical/functional area; accesses and uses other expert resources when appropriate. -
- Demonstrates Adaptability: Handles day to day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities, ambiguity and rapid change; shows resilience inn the face of constraints, frustrations, or adversity; demonstrates flexibility.
- Uses Sound Judgment: Makes timely, cost effective and sound decisions; makes decisions under conditions of uncertainty.
- Shows Work Commitment: Sets high standards of performance; pursues aggressive goals and works efficiently to achieve them.
- Commits to Quality: Emphasizes the need to deliver quality products and/or services; defines standards for quality and evaluated products, processes, and service against those standards; manages quality; improves efficiencies.
PHYSICAL DEMANDS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range.
WORK ENVIRONMENT:
The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites. - 10 Days Ago
Admission Coordinator
- Recover-Care
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Springs, KS
FULL_TIME
- As the Admission Coordinator you are responsible for developing census and quality mix by providing prospective patients and/or responsible parties with appropriate information and assistance to the n...
- 7 Days Ago
Staffing Coordinator
- Recover-Care
-
Beloit, KS
FULL_TIME
- Staffing coordinators ensure that they set schedules in a way that each shift within the facility is appropriately covered. This may involve rotating internal employees to provide quality care in the ...
- 1 Month Ago
Staffing Coordinator
- Amada Senior Care
-
Wichita, KS
FULL_TIME
- Amada Senior Care is looking for Staffing Coordinator who ensures a high standard of quality and safety in the delivery of Home Health Care services, and is responsible for the external recruitment of...
- 11 Days Ago
MDS Coordinator
- Life Care Center of Andover
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Andover, KS
FULL_TIME
- Position Summary:The RN MDS Coordinator coordinates and assists with completion and submission of accurate and timely interdisciplinary MDS Assessments, CAAs, and Care Plans according to CMS RAI Manua...
- 22 Days Ago
Volunteer Coordinator
- Angels Care Home Health
-
Wichita, KS
VOLUNTEER
- Volunteer Coordinator Angels Care Hospice Why Choose Angels Care Hospice? Angels Care Hospice has a simple philosophy: WE SERVE PATIENTS. Over the past 20 years, we have grown to be one of the largest...
- 1 Month Ago
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0 Managed Care Coordinator jobs found in Salina, KS area
RN/LPN
- Legacy at Salina
-
Salina, KS
- What You Can Expect: Our RNs|LPNs|LVNs love Legacy at Salina for the meaningful, rewarding work and the excellent team e...
- 4/19/2024 12:00:00 AM
$1,000 Sign on Bonus Certified Nursing Assistant (CNA) Day Shift
- Recover-Care Healthcare
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Salina, KS
- Certified Nursing Assistant CNA $1,000 Sign-On Bonus We are looking for the best Certified Nursing Assistant (CNAs) to p...
- 4/19/2024 12:00:00 AM
Travel Nurse RN - Med Surg / Telemetry - $1,742 per week
- Hiring Now!
-
Salina, KS
- Fusion Medical Staffing-Nursing is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Salina, Ka...
- 4/19/2024 12:00:00 AM
Driver / Warehouse
- Consolidated Electrical Distributors
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Salina, KS
- Summary Job title: Driver / Warehouse Job ID: 202466650001 Department: Salina - RES Location: KS-Salina Description Summ...
- 4/19/2024 12:00:00 AM
PRN RN Salina
- Wesley Healthcare at Home
-
Salina, KS
- Description Introduction We are looking for a PRN RN to cover Salina and surrounding areas. Do you have the career oppor...
- 4/19/2024 12:00:00 AM
Summer Camp Counselor ($11.00 - $13.00)
- Salina Family YMCA
-
Salina, KS
- POSITION SUMMARY Under the direction of the SACC Coordinator, the Camp Counselor is responsible for working with youth i...
- 4/18/2024 12:00:00 AM
Registered Nurse RN/ LPN evenings
- Pinnacle Park Nursing & Rehab Center
-
Salina, KS
- Pinnacle Park Nursing & Rehab Center - Registered Nurse RN Description content: We are looking for the best Registered N...
- 4/18/2024 12:00:00 AM
Medicaid Pharmacy Director
- State of Nebraska
-
Lincoln, KS
- The work we do matters! Hiring Agency: Health & Human Services - Agency 25 Location: Nebraska State Office Building - Li...
- 4/16/2024 12:00:00 AM
About Salina, Kansas
Salina is located at 38°50′25″N 97°36′41″W / 38.84028°N 97.61139°W / 38.84028; -97.61139 (38.8402805, -97.6114237) at an elevation of 1,224 feet (373 m). Located in north-central Kansas at the intersection of Interstate 70 and Interstate 135, it is 81 miles (130 km) north of Wichita, Kansas, 164 miles (264 km) west of Kansas City, Missouri, and 401 miles (645 km) east of Denver, Colorado.
Salina lies in the Smoky Hills region of the Great Plains approximately 6 miles (9.7 km) west-southwest of the confluence of the Saline and Smoky Hill Rivers. The Smoky Hill River runs north then northeast...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$45,517 to $78,113
Salina, Kansas area prices
were up 1.3% from a year ago
were up 1.3% from a year ago
What does a Managed Care Coordinator do?
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