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)
JOB SUMMARY:
This individual will be responsible for designated areas of organizational operations including, but not limited to client intakes and service oversight, service evaluations, originating service plans, and supervising care. The Client Care Coordinator will directly interface with clients.
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FLSA STATUS:*
*Exempt
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QUALIFICATIONS:
To perform this job successfully, the individual in this position must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the minimum knowledge, skills, abilities, certifications, and educational experience required.
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PHYSICAL DEMANDS & WORK ENVIRONMENTThe physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions. While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands or fingers, handle, or feel objects, tools or controls. The employee is occasionally required to stand; walk; sit; reach with hands and arms. The employee must occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this position include close vision distance vision, peripheral vision, and the ability to adjust focus. The work environment is in an office and/or indoors in a resident’s home and may contain a potential exposure to illness and/or body fluids. The noise level in the work environment is usually moderate.
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Job Type: Full-time
Pay: $17.00 - $22.00 per hour
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Work Location: In person
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