Managed Care Coordinator jobs in Wisconsin

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
  • Family Health Center of M
  • Ladysmith, WI FULL_TIME
  • The Managed Care Coordinator completes insurance requirements and provides case management as needed for services performed in various patient seeing settings. The individual obtains and provides insurance benefit information to patients and patient care departments. The Managed Care Coordinator assists patients and providers with developing strategies for alternative options for non-covered services by communicating with the provider, patient, insurance carrier and Patient Assistance Counselor.

    JOB QUALIFICATIONS 

    EDUCATION

    For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation.

    Minimum Required: High school diploma or equivalent. Successful completion of a medical terminology and an anatomy & physiology course, per departmental procedures, within one year of hire.

    Preferred/Optional: Successful completion of a medical terminology and an anatomy & physiology course at time of hire. Graduate of a Medical Assistant, Health Unit Coordinator or Health Care Business Service program.

    EXPERIENCE

    Minimum Required: Two years’ experience in a medical business office or health care setting. Prior experience should include working with and obtaining insurance eligibility and benefit information.

    Preferred/Optional: None

    CERTIFICATIONS/LICENSES

    The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position.

    Minimum Required: For positions hired within the dental centers: Basic Life Support (BLS) awarded by the American Heart Association within one year of hire.

    Preferred/Optional: Basic Life Support (BLS) awarded by the American Heart Association at time of hire.


    Monday - Friday; 8:00 AM - 5:00 PM
    40
  • 10 Days Ago

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Managed Care Coordinator
  • Family Health Center of M
  • Medford, WI FULL_TIME
  • The Managed Care Coordinator completes insurance requirements and provides case management as needed for services performed in various patient seeing settings. The individual obtains and provides insu...
  • 23 Days Ago

F
Managed Care Coordinator
  • Family Health Center of M
  • Chippewa Falls, WI FULL_TIME
  • The Managed Care Coordinator completes insurance requirements and provides case management as needed for services performed in various patient seeing settings. The individual obtains and provides insu...
  • 1 Month Ago

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Managed Care Coordinator
  • Family Health Center of M
  • Neillsville, WI FULL_TIME
  • The Managed Care Coordinator completes insurance requirements and provides case management as needed for services performed in various patient seeing settings. The individual obtains and provides insu...
  • 1 Month Ago

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RN Care Manager
  • Managed Health Services Wisconsin
  • Racine, WI FULL_TIME
  • You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offeri...
  • 1 Month Ago

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RN Care Manager
  • Managed Health Services Wisconsin
  • Carlton, WI FULL_TIME
  • You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offeri...
  • 1 Month Ago

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Manager Care Coordination
  • hireneXus Research
  • San Francisco, CA
  • Manager Care Coordination Population Health San Francisco Bay Area Here are some of the benefits our client offers! HUGE...
  • 4/23/2024 12:00:00 AM

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, ...
  • 4/23/2024 12:00:00 AM

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Credential and Managed Care Coordinator
  • Us Oncology Network-wide Career Opportunities
  • Norfolk, VA
  • OverviewVirginia Oncology Associates, the largest group of medical professionals in Hampton Roads and Northeast North Ca...
  • 4/22/2024 12:00:00 AM

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RN - Registered Nurse Case Manager - Care Coordination
  • Geisinger
  • Wilkes Barre, PA
  • Job Title: RN - Registered Nurse Case Manager - Care Coordination Location: Wilkes-Barre, Pennsylvania Job Category: RN ...
  • 4/22/2024 12:00:00 AM

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Case Manager (Care Coordinator)
  • Pacifica Hospital of the Valley
  • Los Angeles, CA
  • Job Description Job Description CARE COORDINTOR (CASE MANAGER) BEHAVIORAL HEALTH URGENT CARE CENTER (OUTPATIENT CLINIC) ...
  • 4/20/2024 12:00:00 AM

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Manager Care Coordination
  • Hirenexus Research
  • San Francisco, CA
  • Manager Care Coordination Population Health San Francisco Bay Area Here are some of the benefits our client offers! HUGE...
  • 4/20/2024 12:00:00 AM

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Managed Care Coordinator - Referrals
  • Beth Israel Lahey Health
  • Plymouth, MA
  • **When you join the growing BILH team, you're not just taking a job, youre making a difference in peoples lives.** **Job...
  • 4/19/2024 12:00:00 AM

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Case Manager (Care Coordinator)
  • Pacifica Hospital of the Valley
  • Los Angeles, CA
  • Job Description Job Description CARE COORDINTOR (CASE MANAGER) BEHAVIORAL HEALTH URGENT CARE CENTER (OUTPATIENT CLINIC) ...
  • 4/19/2024 12:00:00 AM

Wisconsin is bordered by the Montreal River; Lake Superior and Michigan to the north; by Lake Michigan to the east; by Illinois to the south; and by Iowa to the southwest and Minnesota to the northwest. A border dispute with Michigan was settled by two cases, both Wisconsin v. Michigan, in 1934 and 1935. The state's boundaries include the Mississippi River and St. Croix River in the west, and the Menominee River in the northeast. With its location between the Great Lakes and the Mississippi River, Wisconsin is home to a wide variety of geographical features. The state is divided into five dist...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$48,669 to $83,524

Managed Care Coordinator in New Orleans, LA
Health systems must meet the operational challenge of managing provider data for thousands of participating providers in their value-based care networks.
January 11, 2020
Managed Care Coordinator in Gainesville, FL
Many telehealth programs give patients easy access to any additional educational materials provided by their health plan or primary care provider.
December 23, 2019
Managed Care Coordinator in Houston, TX
Works with relevant parties to ensure deliverable from all parties are achieved in accordance with strategic timelines.Maintains CHSLI master list of service locations (facility, professional and continuing care)Assists in the resolution of referral, authorization and claims payment issuesSupports Directors in effort to educate and assist Hospital departments in meeting internal and MCO operational requirements.
December 27, 2019