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)
Job Summary: The Care Coordinator is key member of our team, who will deliver continuous patient monitoring and care coordination by assisting (virtually) chronically ill patients from a remote setting. The Care Coordinator will work closely with the patients that are enrolled in a Chronic Care Management program (CCM) and/or Remote Physiological Monitoring program (RPM). The Care Coordinator will communicate effectively and efficiently the patient’s care plan by educating via telephone each month.
Duties and Responsibilities:
Requirements:
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