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)
Why BayCare?
We are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that’s built on a foundation of trust, dignity, respect, responsibility and clinical excellence.
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Facility: BayCare Health System, Tampa Startup-BHS
Location: Park Place
Status: Full Time, Exempt: No
Shift Hours: 8
Shift: Shift 1
Shift 1 = Days, 2 = Evenings, 3 = Nights, 4 = Varies
Weekend Work: Occasional
On Call: No
Does this position fall under CMS guidelines for COVID19 vaccine or exemption?: No - CMS Requirements Do Not Apply
How often will this team member be working remotely? Hybrid
Equal Opportunity Employer Veterans/Disabled
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