Managed Care Coordinator jobs in Southfield, MI

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
  • Detroit, MI 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.
  • 29 Days Ago

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Registered Nurse - Hospice Acute Care Coordinator - Part Time - Days
  • Hospice Acute Care Coordinator - Part Time - Days - Henry Ford Health - Careers Careers
  • Detroit, MI PART_TIME
  • Registered Nurse - Hospice Acute Care Coordinator - Part Time - Days GENERAL SUMMARY: Functions as a care coordinator for Hospice within the hospice setting. Assesses and identifies patient needs in a...
  • 15 Days Ago

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Home Care Scheduling Coordinator
  • Anytime Care
  • Chesterfield, MI FULL_TIME
  • A home care scheduler plays a crucial role in ensuring that home health care aides provide compassionate care, prioritizing the well-being of patients. Their responsibilities include creating schedule...
  • 19 Days Ago

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Client Care Coordinator
  • FirstLight Home Care-Livonia
  • Livonia, MI FULL_TIME
  • If you are an AMAZING, COMPASSIONATE person who wants to make a difference in the lives of many people and want to make great money working at an extraordinary company, then keep reading! Do you love ...
  • 4 Days Ago

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Medical Care Coordinator
  • Physician Care Solutions, PC
  • Troy, MI FULL_TIME
  • Physician Care Solutions is looking for a highly motivated and energetic medical assistant to join our team! This position is responsible for reaching out to qualifying patients and on-boarding them t...
  • 25 Days Ago

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Client Care Coordinator
  • National Home Care LLC
  • energy, MI FULL_TIME
  • Are you a high-energy, self-directed, and persistent individual, if yes we want you on our team.Join our team and be part of our mission to give the highest quality of affordable Home Care. We believe...
  • 1 Month Ago

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0 Managed Care Coordinator jobs found in Southfield, MI area

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Patient Care Coordinator
  • HomeMD HouseCall Services
  • Waterford, MI
  • Job Description Job Description The position involves acting as a liaison and advocate for elderly clients in their home...
  • 4/18/2024 12:00:00 AM

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Dental Patient Care Coordinator
  • Forest Dental Associates PLLC
  • Utica, MI
  • Job Description Job Description Immediate opening for a dental patient care coordinator for our family dental practice. ...
  • 4/18/2024 12:00:00 AM

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Care Coordinator - RN or LMSW (Must reside in Wayne or Macomb Counties in MI)
  • AmeriHealth Caritas
  • Southfield, MI
  • Your career starts now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are pa...
  • 4/17/2024 12:00:00 AM

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Health Navigator
  • EPIC Health Systems
  • Southfield, MI
  • Job Description Job Description At EPIC Health, we're committed to providing exceptional care to our patients, and we're...
  • 4/17/2024 12:00:00 AM

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Nurse Practitioner (Family Medicine)
  • EPIC Health Systems
  • Detroit, MI
  • Job Description Job Description EPIC Health's mission is to provide exceptional healthcare for our community. We are a M...
  • 4/17/2024 12:00:00 AM

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Physician Assistant (Family Medicine)
  • EPIC Health Systems
  • Detroit, MI
  • Job Description Job Description EPIC Health's mission is to provide exceptional healthcare for our community. We are a M...
  • 4/17/2024 12:00:00 AM

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Care Coordinator (Brighton, MI)
  • Right At Home
  • Novi, MI
  • Join Central Michigan's Best Care Team Are you a caring, compassionate person who is a great listener? Would you like to...
  • 4/16/2024 12:00:00 AM

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Patient Care Coordinator-Front Desk 1
  • Dexter Oral Surgery & Implant Center
  • Dexter, MI
  • Job Description Job Description Patient Care Coordinator-Front Desk 1 The employees of Dexter Oral Surgery & Implant Cen...
  • 4/15/2024 12:00:00 AM

Southfield is a city in Oakland County of the U.S. state of Michigan. It is a northern suburb of Detroit. As of the 2010 census, the city had a population of 71,739. A part of Metro Detroit's upscale office market, the city's marque is a cluster of five golden skyscrapers – known as the "Golden Triangle" – that form the contemporary 2,200,000 square feet (204,400 m2) Southfield Town Center office complex with a Westin Hotel and a conference center. In addition, a 33-story luxury residential high-rise is separate from the complex. To the west, near the confluence of I-696/Reuther Freeway and M...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$49,556 to $85,045
Southfield, Michigan area prices
were up 1.2% 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