Managed Care Coordinator jobs in Yakima, WA
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)
Recently Added Managed Care Coordinator jobs
- Yakima Valley Farm Workers Clinic
-
Yakima, WA
FULL_TIME
-
Job Brief
RN - Managed Care Program ManagerYakima, WA
Employment duration: Full time Exempt Status: Exempt Offer Relocation?: Yes ID: 12373We are looking for an experienced RN manager with successful care management implementation experience who can lead and design chronic care management models for Medicare and other high-risk populations. This position will take the lead in coaching, mentoring, and guiding our dedicated team, ensuring we are meeting our KPIs and enhancing our services. You will be responsible for program compliance and creating positive relationships with providers, clinical staff, health educators, and community partners.
Working at Yakima Valley Farm Workers Clinic means living in the beautiful Pacific Northwest. You will have the opportunity enjoy spectacular wilderness areas, scenic ocean beaches and crystal-clear lakes and rivers. Because of the Cascade mountain range, the Northwest has two distinct climates: The west side is lush and green. Theis located in Eastern Washington where, shielded from the rain-filled clouds by the high mountains, it tends to be sunny and arid. Farms and orchards here produce a bounty of fruits, berries, vegetables, hops, and wine grapes.
What We Offer
- Salary $87,000 -$116,000 DOE with ability to go higher for highly experienced candidates.
- 100% employer-paid health insurance for employees including Medical, Dental, Vision, Rx, 24/7 telemedicine; profit sharing, 403(b) retirement plan, generous paid time off, paid holidays, uniform allowance, and more.
- Relocation allowance available.
- Coaches, mentors and trains direct report staff. Provides continuous performance management and conducts employee performance evaluations. Addresses performance and/or behavior issues, clarifying expectations and providing feedback.
- Identifies staff training needs, develops and conducts appropriate training for staff.
- Supports staff growth and development. Assesses the educational and experience needs of all levels of staff in collaboration with the individual. Encourages staff to seek educational opportunities incorporating job related training in addition to mandatory training.
- Participates in the recruitment and selection of staff. Provides orientation to outline job requirements and expectations, policies and procedures, and proper use of tools and equipment.
- Oversee program requirements and ensure program compliance. Provides review and analysis of adherence to grant/contract program requirements, objectives and goals. Responds to questions regarding grant/contract and program compliance to external sources, including State and Agency contacts.
- Assigns work to nurses, case managers and subordinates based on competency of staff and volume of patient caseloads.
- Ensures the patient care environment supports the delivery of excellent care. Identifies any obstacles and makes recommendations for improvement in collaboration with the patient's care team.
- Supervises nurses, case managers and ensures compliance with Customer Service Policies.
- Implements program level policies and procedures for assigned program. Recommends improvements to current policies and procedures to improve program effectiveness and performance.
- Oversees and complies with program evaluation requirements and ensures that direct reports comply with requirements.
- Monitors and reviews program progress on a regular basis to ensure program requirements are being met.
- Create agenda and schedule regular departmental meetings based on current needs.
- Maintains professional and working knowledge of pertinent state and federal regulations and professional standards.
- Promotes, develops, and maintains strong, collaborative relationships with community partners.
- Directs staff to develop patient Care Plans based on health history, health behavior, and recommendations from the patient's care team.
- Serves as a program resource on program guidelines and requirements as defined by governing bodies.
- Participates in local, state, and federal efforts to improve service delivery and program effectiveness.
- Completes monthly reports and submits them following the prescribed timeline.
- Develops and monitors program budget to ensure it is balanced and that expenditures are allowable and reasonable.
- Performs other duties as assigned.
- Education: Bachelor's Degree in Nursing. Associates Degree and Two years' additional directly related experience may be substituted for the required education. HS Diploma and Four years' additional directly related experience may be substituted for the required education.
- Experience: Five years' experience in care coordination, case/care management, utilization/resource management, quality management, and/or transition of care. This includes two years' experience supervising staff.
- Professional Licenses/Certificates/Registration: Registered Nurse (RN) with current licensure to practice in Washington State. Case Management Certification (CCM) is preferred.
- Knowledge/Skills/Abilities: Bilingual (English/Spanish) preferred. This position is not eligible for bilingual differential pay. Knowledge of utilization management, quality improvement, discharge planning, and cost management. Knowledge of the uses and effects of medications. Knowledge of cultural differences and ability to work effectively with culturally diverse populations. Effective verbal, written and listening communication skills. Skills to effectively lead and manage a department and a team. Skills to delegate responsibilities and motivate staff to complete tasks. Skills to exercise independent judgement and discretion. Skills to develop effective working relationships with social service providers, partners, referral/payer sources. Skills to effectively interact with a variety of patients, patients' families and employees in a professional manner. Basic proficiency with a variety of computer programs including Microsoft Outlook, Word, Excel and PowerPoint.
- We will consistently trust one another to work for the common good.
- We will foster integrity by demonstrating ethical behavior and insisting on doing what we say we will do.
- We will demonstrate transparency by being candid and truthful no matter the risk.
- We will create partnerships to strengthen ourselves and our community.
- We will fight for just treatment for all individuals.
- We will let joy in.
- We have the courage to be an agent of change and refuse anything short of excellence.
- 22 Days Ago
Essential Functions/Responsibilities/Duties
Qualifications
About YVFWC
We serve more than 197,000 patients across 28 medical clinics, 15 dental clinics, 11 pharmacies, and 49 program sites in two states. We are Level 3 Certified as a Patient-Centered Medical Home (PCMH). With integrated services including medical, dental, pharmacy, orthodontia, primary care nutritional counseling, autism screening, and primary care behavioral health, YVFWC's patient-centered model of care offers patients the full spectrum of care and shelter assistance, energy assistance, weatherization, HIV and AIDS counseling and testing, home visits, and four mobile medical/dental clinics.
Working at YVFWC
Working in our organization means being the passionate champion for those who have no voice. It means having the opportunity to work with underserved populations and with peers committed to the same work.
At Farm Workers Clinic
Our mission celebrates diversity. We are committed to equal opportunity employment.
- Yakima Valley Farm Workers Clinic
-
Presson Place, WA
FULL_TIME
- Provides daily oversight, leadership, support, training, and direction to clinical care management staff. Supports the Integrated Care Program Director and other department leaders with the developmen...
- 10 Days Ago
- COMPREHENSIVE HEALTHCARE
-
Yakima, WA
OTHER
- Job Details Job Location: Yakima - Yakima, WA Position Type: Full Time Education Level: Bachelor's degree Salary Range: $23.65 - $29.56 Hourly Job Shift: Day DescriptionWho is Comprehensive Healthcare...
- 1 Month Ago
- Community Health of Central Washington
-
Yakima, WA
FULL_TIME
- RN Care Coordinator$34.62 - $43.74 $10k Sign on! Community Health of Central Washington (CHCW) is committed to attract and retain a diverse staff. We will honor your experiences, perspectives, and uni...
- 11 Days Ago
- Columbia Basin Hospital
-
Ephrata, WA
FULL_TIME
- JOB SUMMARY The Clinic Care Coordinator RN coordinates team-based care to provide health services to individuals, through effective partnerships with patients, their caregivers/families, community res...
- 3 Days Ago
- Public Hospital District 3 of Grant County WA
-
Ephrata, WA
FULL_TIME
- JOB SUMMARY The Clinic Care Coordinator RN coordinates team-based care to provide health services to individuals, through effective partnerships with patients, their caregivers/families, community res...
- 4 Days Ago
- Current Active Filter
- Yakima, WA
Clear All
- Filter Jobs By posted time
- Within 1 Day
- Within 2-7
- Within 1 Month
- Within 3 Months
0 Managed Care Coordinator jobs found in Yakima, WA area
- Yakima Valley Farm Workers Clinic
-
Yakima, WA
- Job Brief RN - Managed Care Program Manager Yakima, WA Employment duration: Full time Exempt Status: Exempt Offer Reloca...
- 4/18/2024 12:00:00 AM
- Affordable Care
-
Yakima, WA
- **Overview** **Come join our team as a Dental Assistant!** This position is more than just a job, it is an opportunity t...
- 4/18/2024 12:00:00 AM
- COMPREHENSIVE HEALTHCARE
-
Yakima, WA
- Job Details Job Location Yakima - Yakima, WA Position Type Full Time Education Level Bachelor's degree Salary Range $23....
- 4/18/2024 12:00:00 AM
- Cintas
-
Yakima, WA
- **Requisition Number:** 169369 **Job Description** Cintas is seeking a Production Associate Bulk Load Builder to support...
- 4/18/2024 12:00:00 AM
- Cintas
-
Yakima, WA
- **Requisition Number:** 169528 **Job Description** Cintas is seeking a Production Associate Garment/Linen/Bulk Product F...
- 4/18/2024 12:00:00 AM
- Aveanna Healthcare
-
Yakima, WA
- LPN needed for afternoon and night shifts in Yakima. LPN Pay Rates: $29 - $38 *Case Specific Rate Only Qualified and int...
- 4/18/2024 12:00:00 AM
- CHC Wellbeing
-
Yakima, WA
- Community Outreach Liaison $19.76 - $25.34 Community Health of Central Washington (CHCW) is committed to attract and ret...
- 4/17/2024 12:00:00 AM
- Aveanna Healthcare
-
Yakima, WA
- RN needed for night shits in Yakima. RN Pay Rates: $35 - $45 HR* *Case Specific Rate Only Qualified and interested candi...
- 4/16/2024 12:00:00 AM
About Yakima, Washington
were up 2.9% from a year ago