Managed Care Coordinator jobs in Westland, 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.
  • 1 Month 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...
  • 19 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...
  • 25 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...
  • Just Posted

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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 ...
  • 8 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 Westland, 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...
  • 4/23/2024 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. ...
  • 4/23/2024 12:00:00 AM

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Director of Case Management
  • Vodastra
  • Detroit, MI
  • Job Description Job Description As a Director of Case Management, you'll oversee department operations, ensuring adequat...
  • 4/23/2024 12:00:00 AM

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Client Care Coordinator - Home Care
  • CareOne Senior Care
  • Novi, MI
  • Job Description Job Description Client Care Coordinator / Quality Assurance The Client Care Coordinator is responsible f...
  • 4/23/2024 12:00:00 AM

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Patient Care Coordinator
  • TEKsystems
  • Madison Heights, MI
  • *Description:* Job Description Remember, nose rings and visible tattoo's are unacceptable for hire in their bi-laws. Tat...
  • 4/22/2024 12:00:00 AM

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Pharmacy Technician, Specialty Care Coordinator
  • Albertsons
  • Livonia, MI
  • Job Description About the company MedCart, a division of Albertsons Companies, is an innovative industry leader in commu...
  • 4/22/2024 12:00:00 AM

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Patient Care Coordinator
  • Ear Center audiology
  • Dearborn, MI
  • Job Description Job Description Duties & Responsibilities Provide administrative support of the front desk by answering ...
  • 4/21/2024 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...
  • 4/20/2024 12:00:00 AM

Westland is a city in Wayne County in the U.S. state of Michigan. It is located about 16 miles (26 km) west of downtown Detroit. As of the 2010 census, the city had a total population of 84,094. It is the 10th largest city and 12th largest municipality in Michigan. According to the United States Census Bureau, the city has a total area of 20.45 square miles (52.97 km2), of which 20.43 square miles (52.91 km2) is land and 0.02 square miles (0.05 km2) is water....
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$49,901 to $85,637
Westland, 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