Managed Care Coordinator jobs in West Covina, 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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Managed Care Enrollment Coordinator
  • Arroyo Vista Family Health Center
  • Los Angeles, CA FULL_TIME
  • Salary Range: $21.22 - $23.90 Hourly

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    Summary:*
    Under the direct supervision of the Director of Managed Care Services, the Managed Care Enrollment Coordinator is responsible for coordinating and implementing member’s enrollment into Managed Care Health Plans and selection of Primary Care Physician, transfers of plans and providers, eligibility verification, information and education for patients. Prepares monthly reports, detailing enrollment for the current month and performs plan relations and other duties as assigned.
    DUTIES AND RESPONSIBILITIES:

    • Responsible for receiving patients and public in a professional and courteous manner.
    • Responsible for verification of Health Plan status (eligibility) for new and established patients.
    • Responsible for assisting patients and their families with plan and provider transfers and maintaining data about those assisted.
    • Responsible for providing patients with information and education on Medi-Cal, Medicare and Covered CA Managed Care options and on the health plan enrollment process.
    • Responsible for referring patients to the Department of Public Social Services Worker(s) as needed.
    • Responsible for assisting Medi-Cal, Medicare Advantage, AIM and Covered CA patients with enrolling into health plan coverage.
    • Responsible to assist consumers with disenrollment or Requests for Medi-Cal Exemptions when necessary, per patient’s choice and maintain data on said assistance.
    • Responsible for scheduling appointments for Managed Care patients to assist with applications and update patient registration information needed.
    • Responsible for entering notes and alerts in the EHR Practice Management system for Managed Care patient changes, each time a change is made.
    • Responsible for follow-up on courtesy visits of Managed Care patients to ensure completion of transfer.
    • Responsible for maintaining data on the number of new and established patients (detailed in Monthly Enrollment Report).
    • Responsible for reporting data on Medi-Cal and Managed Care enrollments and disenrollments on a monthly basis.
    • Responsible for maintaining New Patient Database for Initial Health Assessments (IHA), schedule IHA appointments for new patients, survey and follow up on show rates for IHA compliance.
    • Responsible for handling telephone calls to and from patients, health plans, IPA and Health Care Options regarding managed care issues, in a timely and effective manner, and logging information on telephone interactions.
    • Responsible for maintaining efficient flow of Managed Care patients.
    • Responsible for accurately documenting all Managed Care enrollment forms.
    • Responsible for assisting patients with maintaining active status in their current Managed Care Plan, including Re-determination and on-hold status follow up.
    • Responsible for initiating solutions when a Managed Care problem arises for patients who wish to be seen at Arroyo Vista.
    • Responsible for communicating problems/concerns/solutions when necessary to the appropriate staff members.
    • Responsible for an understanding of the Managed Care and Patient Enrollment Coordinator Manual.
    • Responsible for following all Agency safety and health standards, regulations, procedures, policies, and practices.
    • Actively participates in the Quality Management Program, Safety Program, Emergency Preparedness and Infection Control Programs.
    • Responsible for attending trainings and seminars regarding Managed Care plans accepted at Arroyo Vista.
    • Responsible to take such steps necessary to allow Arroyo Vista to realize the benefits of the Electronic Health Records system including the adoption, implementation, upgrading and meaningful use of such technology as requested or required by Arroyo Vista or other federal or state authority.
    • Performs other duties as assigned.

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    REQUIREMENTS:*

    • Associates Degree and one year Managed Care Enrollment experience, or 2-4 years’ experience in the health care field.
    • Bilingual (English/Spanish).
    • Two years experience with customer service and satisfactory written, telephone, and verbal communication skills.
    • Computer literate in health information system(s) and Microsoft Office applications with ability to type 35 WPM.
    • Effective verbal and written communication skills with ability to be thorough, accurate, and detail oriented.
    • Reliable transportation with the ability to get to other locations as required to perform the functions of the position.
    • Experience in Managed Care Enrollment, Medical Front/Back Office and/or Financial Screening preferred.
    • Ability to work well with others in a professional team oriented environment.
    • Complete Certified Application Assistant (CAA) certification, within first month of hire.

    Job Type: Full-time

    Pay: $16.94 - $22.92 per hour

  • 8 Days Ago

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Supervisor
  • Absolute Managed Care
  • Compton, CA FULL_TIME
  • About us Bailey's Place Day Program is a small business in Compton, CA that provides activities, job skills, and different forms of social engagement for adults with disabilities. We are passionate ab...
  • 8 Days Ago

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Director of Managed Care Contracts
  • Rockport Healthcare Services
  • Los Angeles, CA FULL_TIME
  • SUMMARY: The Director of Managed Care Contracts is responsible for the management of all managed care and capitation contracts/amendments, including, but not limited to, professional and facility fee ...
  • 20 Days Ago

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Managed Care Collector
  • Ethos Management (Servicing AHMC Hospitals)
  • Alhambra, CA FULL_TIME
  • Overview: Ethos Management, Inc provides Collections, Billing, Accounts Receivable and Customer Service support to AHMC Hospitals to assist with their revenue cycle objectives. The Managed Care Collec...
  • 20 Days Ago

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Managed Care Biller - Rockport
  • Rockport Healthcare Services
  • Los Angeles, CA FULL_TIME
  • Sign on bonus of $5,000 for new hires. Essential Job Functions: 1. Submits reimbursement claims to third parties (insurance health plans, government agencies, etc.) for services rendered at assigned f...
  • 24 Days Ago

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Managed Care - Contracts Manager
  • Glendora Hospital
  • Santa Fe, CA FULL_TIME
  • College Health Enterprises is one of the fastest growing health systems in Southern California. We are dedicated to the highest quality of customer services delivered with a with a sense of warmth fri...
  • 1 Day Ago

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0 Managed Care Coordinator jobs found in West Covina, CA area

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Care Coordinator
  • Pac Ventures Llc
  • Valencia, CA
  • Job Description Job Description Benefits/Perks Flexible Scheduling Competitive Compensation Careers Advancement Job Summ...
  • 3/29/2024 12:00:00 AM

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Care Coordinator
  • Premium Health
  • Irvine, CA
  • Job Description Job Description Due to the large volume of applicants for this job, we prefer to get a video along with ...
  • 3/29/2024 12:00:00 AM

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Care Coordinator
  • Interim Healthcare of Irvine
  • Irvine, CA
  • Job Description Job Description We are seeking an in-office Care Coordinator plus Recruiter to join our Interim HealthCa...
  • 3/28/2024 12:00:00 AM

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Care Coordinator
  • Center for Family Health and Education
  • Los Angeles, CA
  • Job Description Job Description We are seeking a Care Coordinator to become a part of our team! You will coordinate medi...
  • 3/27/2024 12:00:00 AM

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Manager, Care Coordination
  • SCAN
  • Long Beach, CA
  • About SCAN SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adult...
  • 3/26/2024 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) ...
  • 3/26/2024 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) ...
  • 3/25/2024 12:00:00 AM

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Care Coordinator
  • Partners in Care Foundation
  • Los Angeles, CA
  • Job Description Job Description Qualifications: Pay range $19-22 per hour. In person client visits. Experience: · Two ye...
  • 3/25/2024 12:00:00 AM

West Covina is a city in Los Angeles County, California, located 19 miles (31 km) east of Downtown Los Angeles in the eastern San Gabriel Valley and is part of Greater Los Angeles. The population for the city was 106,098 at the 2010 census....
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$55,323 to $94,946
West Covina, California area prices
were up 3.2% 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