Managed Care Coordinator jobs in Visalia, CA

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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Contract Coordinator, Managed Care
  • Community Medical Centers of Fresno, CA
  • Fresno, CA OTHER
  • Overview

    *All positions are located in Fresno/Clovis CA*

     

    Opportunities for you!

    • Join a Forbes Top 10 CA Employer!
    • Direct impact on quality patient care.
    • Free Continuing Education and certification including BLS, ACLS and PALS
    • Tuition reimbursement, education programs, and scholarships
    • Vacation time starts building on Day 1, and builds with your seniority
    • 403(b) retirement plan with up to 8% matching contributions 
    • Free parking and electric charging
    • Great food options with on-demand ordering

     

    Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community.

    We know that our ability to provide the highest level of care begins with taking care of our incredible teams. Want to learn more? Click here. 

    Responsibilities

    Provide assistance to the Director of Managed Care. Supports, at various levels of responsibility, activities related to the contracting and contract management process for facility, physician, ancillary and CMC health plan contracts. Responsible for contract administration activities, including facilitating and ensuring contract compliance, developing and maintaining contract detail reports, provider databases and demographic information. Responsible for physician contract files including development of contracts and addendums, correspondence and maintenance. Coordinates contract implementation and resolution of contractual issues with payors, facilities, physicians and internal operational staff.

    Qualifications

    Minimum required:

    • Associates degree in Business or Healthcare Administration and 3 years experience in medical office management/billing, insurance or managed care environments. Five years relevant experience may be substituted in lieu of education and experience.

    Preferred:

    • Bachelors degree in Business or Healthcare Administration and four years experience in medical practice, insurance or managed care environments.

    Disclaimers

    • Pay ranges listed are an estimate and subject to change.• If any bonuses are noted, they are only applicable to external hires meeting criteria.

  • 25 Days Ago

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Contract Coordinator, Managed Care
  • Community Health System - CA
  • Fresno, CA FULL_TIME
  • Overview: All positions are located in Fresno/Clovis CA * Opportunities for you! Join a Forbes Top 10 CA Employer! Direct impact on quality patient care. Free Continuing Education and certification in...
  • 18 Days Ago

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Manager of Contracts, Managed Care
  • Community Medical Centers of Fresno, CA
  • Fresno, CA OTHER
  • Overview *All positions are located in Fresno/Clovis CA* We're looking for a Manager of Contracts for Managed Care to join our growing team! In your role, you will be integral to overseeing and suppor...
  • 25 Days Ago

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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Fresno, CA 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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Manager of Contracts, Managed Care
  • Community Health System - CA
  • Fresno, CA FULL_TIME
  • Overview: All positions are located in Fresno/Clovis CA * We're looking for a Manager of Contracts for Managed Care to join our growing team! In your role, you will be integral to overseeing and suppo...
  • 18 Days Ago

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Salon Coordinator
  • Sport Clips - Coordinator - CA205
  • Clovis, CA 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. ...
  • 21 Days Ago

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0 Managed Care Coordinator jobs found in Visalia, CA area

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Per Diem Pharmacist-Clinical
  • Kaweah Health Care District
  • Visalia, CA
  • Kaweah Health is a publicly owned, community healthcare organization that provides comprehensive health services to the ...
  • 3/28/2024 12:00:00 AM

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Nurse Practitioner-Clinics Dinuba
  • Kaweah Health Care District
  • Dinuba, CA
  • Kaweah Health is a publicly owned, community healthcare organization that provides comprehensive health services to the ...
  • 3/28/2024 12:00:00 AM

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Physical Therapist PT for Home Health
  • FeldCare Connects
  • Corcoran, CA
  • FeldCare Connects, an app-based referral network, is seeking an enthusiastic, self-motivated Physical Therapist to deliv...
  • 3/28/2024 12:00:00 AM

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Physician Assistant Urgent Care Court
  • Kaweah Health Care District
  • Visalia, CA
  • Kaweah Health is a publicly owned, community healthcare organization that provides comprehensive health services to the ...
  • 3/27/2024 12:00:00 AM

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Nurse Practitioner-Clinics Woodlake
  • Kaweah Health Care District
  • Woodlake, CA
  • Kaweah Health is a publicly owned, community healthcare organization that provides comprehensive health services to the ...
  • 3/27/2024 12:00:00 AM

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RN, Burn Center, $10K Sign On Bonus
  • Community Health System - CA
  • Fresno, CA
  • Overview: *All positions are located in Fresno/Clovis CA* Up to $10k sign-on bonus available for candidates meeting spec...
  • 3/27/2024 12:00:00 AM

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Per Diem RN-Nurse Practitioner-Throughput
  • Kaweah Health Care District
  • Visalia, CA
  • Kaweah Health is a publicly owned, community healthcare organization that provides comprehensive health services to the ...
  • 3/25/2024 12:00:00 AM

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RN, Burn Center, $10K Sign On Bonus
  • Community Health System - Ca
  • Fresno, CA
  • Overview:*All positions are located in Fresno/Clovis CA* Up to $10k sign-on bonus available for candidates meeting speci...
  • 3/25/2024 12:00:00 AM

Visalia (/vaɪˈseɪliə/ vy-SAYL-ee-ə) is a city situated in the agricultural San Joaquin Valley of California, approximately 230 miles (370 km) southeast of San Francisco, 190 miles (310 km) north of Los Angeles, 36 miles (58 km) west of Sequoia National Park and 43 miles (69 km) south of Fresno. The population was 130,104 as of a 2015 U.S. Census Bureau estimate. Visalia is the 5th largest city in the San Joaquin Valley after Fresno, Bakersfield, Stockton and Modesto; the 44th most populous in California; and 198th in the United States. As the county seat of Tulare County, Visalia serves as the...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$49,415 to $84,805
Visalia, California area prices
were up 2.7% 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