Managed Care Coordinator jobs in Silver Spring, MD

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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Managed Care Coordinator
  • Anthem
  • Alexandria, VA OTHER
  • Managed Care Coordinator

    MUST LIVE WITHIN THE TIDEWATER REGION

    (Accomack County, Chesapeake County, Franklin City, Isle of Wight County, Hampton City, Norfolk City, Newport News City, North Hampton County, Portsmouth City, Suffolk City, Virginia Beach City, VA)

    A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.

    The Managed Care Coordinator is responsible for overall management of member's individual service plan within the scope of position, as required by applicable state law and contract.

    How you will make an impact:

    • Performing telephonic or face-to-face history and program needs assessments using a tool with pre-defined questions for the identification, evaluation, coordination and management of member's program needs.
    • Using tools and pre-defined identification process, identifies members with potential clinical health care needs (including, but not limited to, potential for high risk complications) and coordinates those member's cases with the clinical healthcare management and interdisciplinary team in order to provide care coordination support.
    • The process does not involve clinical judgment; however, some working knowledge of the American Society of Addiction Medicine (ASAM) Criteria is preferred.
    • Manages non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of services.
    • Establishes short and long term goals in collaboration with the member, caregivers, family, natural supports, and physicians. Identifies members that would benefit from expanded services.
    • Travels to worksite and other locations as necessary.

      Minimum Requirements:

      • Requires BA/BS degree
      • A minimum of 1 year of experience working directly with people related to the specific program population or other related community based organizations; or any combination of education and experience which would provide an equivalent background.

        Preferred Skills, Capabilities, and Experiences:

        • For MMP, requires Community Health Worker certification to be obtained within one year of employment.
        • Bachelors / Masters degree in a health or human service field. .
        • BA/BS degree field of study in health care related field preferred.
        • QMHP certification / or CSAC certification highly preferred.
        • 1 year of experience working directly with individuals with substance use disorder highly preferred..
        • Specific education and years and type of experience may be required based upon state law and contract requirements.
        • LMHP, RN/LPN field of study preferred.
        • Behavioral/Mental Health experience

  • 28 Days Ago

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Operations, Coordinator (Executive Assistant Level)
  • Managed Funds Association
  • Washington, DC FULL_TIME
  • Company DescriptionThe Managed Funds Association, based in Washington, DC, New York, and Brussels, represents the global alternative asset management industry. MFA’s mission is to advance the ability ...
  • 13 Days Ago

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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Washington, DC 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 medicatio...
  • 8 Days Ago

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Tapestry Managed Care Analyst - Epic
  • Ampcus, Inc
  • Chantilly, VA FULL_TIME
  • REMOTE. Epic Tapestry certified; build experience in required, min 5 years, 10 years preferred. Premium Billing experience desired.Ampcus is an Equal Opportunity Employer. All qualified applicants wil...
  • 1 Month Ago

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Salon Coordinator
  • Sport Clips - Coordinator - VA107
  • Centreville, VA FULL_TIME
  • Sport Clips is seeking a dynamic and enthusiastic Salon Coordinator to join our team and play a pivotal role in delivering exceptional customer service and ensuring the smooth operation of our salon. ...
  • 20 Days Ago

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Salon Coordinator
  • Sport Clips - Coordinator - VA105
  • Manassas, VA FULL_TIME
  • Sport Clips is seeking a dynamic and enthusiastic Salon Coordinator to join our team and play a pivotal role in delivering exceptional customer service and ensuring the smooth operation of our salon. ...
  • 22 Days Ago

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0 Managed Care Coordinator jobs found in Silver Spring, MD area

5
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, ...
  • 3/29/2024 12:00:00 AM

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Client Care Coordinator
  • Breakaway Physical Therapy, LLC
  • Crofton, MD
  • If you enjoy helping people feel good and get their life back, then join our team! We are a rapidly growing privately-ow...
  • 3/29/2024 12:00:00 AM

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Patient Care Coordinator
  • U.S. Physical Therapy
  • Herndon, VA
  • Overview Clinic Name: The Jackson Clinics Position: Patient Care Coordinator Location: Herndon, Virginia Employment Type...
  • 3/29/2024 12:00:00 AM

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Care Coordinator
  • Gastro Health
  • Reston, VA
  • Gastro Health is seeking a Full-Time Care Coordinator to join our team! Gastro Health is a great place to work and advan...
  • 3/28/2024 12:00:00 AM

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Extended Care Coordinator
  • German International School Washington D.C.
  • Potomac, MD
  • Job Description Job Description Who we are: The German International School Washington D.C. is a leading international s...
  • 3/28/2024 12:00:00 AM

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Palliative Care Coordinator
  • Curo Health Services
  • Fairfax, VA
  • Our Company Empatia is a member of the Gentiva family - an industry leader in hospice, palliative, home health, and pers...
  • 3/28/2024 12:00:00 AM

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ED CARE COORDINATOR
  • LifeBridge Health
  • Randallstown, MD
  • The Emergency Department Care Coordinator, in collaboration with the clinical team to include the medical provider, deli...
  • 3/28/2024 12:00:00 AM

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Customer Care Coordinator
  • Numotion
  • Baltimore, MD
  • Customer Care Coordinator Tracking Code 8079-128 Job Description By joining Numotion, you will be a part of the nations ...
  • 3/26/2024 12:00:00 AM

Silver Spring is an unincorporated community, large village, suburb of Washington, D.C., and census-designated place located inside the Capital Beltway in Montgomery County, Maryland, United States. It had a population of 79,483, according to the 2017 official estimate by the United States Census Bureau, making it the fourth most populous place in Maryland, after Baltimore, Columbia, and Germantown, and the second largest in Montgomery County after Germantown. Inner Silver Spring consists of the following neighborhoods: Downtown Silver Spring, East Silver Spring, Woodside, North Woodside, Wood...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$55,229 to $94,784
Silver Spring, Maryland area prices
were up 1.3% 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