Managed Care Coordinator jobs in Baton Rouge, LA

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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Director - Managed Care Contracting & Development
  • Baton Rouge General
  • Baton Rouge, LA FULL_TIME
  • Responsible to lead development and execution of the Managed Care strategy, including all managed care related payor relations initiatives. Will serve as a key leader and critical liaison between the managed care payers and General Health System operations and other support services (Operations Leadership, Case Management, Sales and Marketing, Business Office, Finance, etc.). Collaborates with market colleagues to identify and execute on business development, revenue growth opportunities, systematic clinical and/or operational issues with managed care or 3rd party payors. This position is both internal and external facing, develops and maintains effective working relationships with key stakeholders with managed care payers in the market. Executes on business development opportunities by focusing on General Health System’s value proposition and drives increased managed care penetration across the continuum of care.
    Develops and updates the Managed Care Strategy in collaboration with Operational leadership and the Managed Care Steering Committee, including documentation of goals, activities, and progress achieved.
    • Determine the optimal allocation of necessary resources to effectively manage the relationships with payers in the market, including provider organizations under a contractual or risk-bearing agreements include value-based agreements
    • Builds and maintains managed care payer relationships in support of the Managed Care strategy to ensure (i) appropriate contact and communication at all necessary levels within the payor organization (e.g. contracting, medical management, discharge planning, etc.), (ii) communication of General Health System’s value proposition (iii) resolving “barriers to entry”, and (iv) consistency of messaging in general
    • Owns and manages all aspects of assigned portfolio of managed care and associated payor relationships, including (i) identifying opportunities to grow our managed care business and scheduling meetings with the relevant payer contacts, (ii) creating tailored presentations / materials, (iii) seeking preparation and attendance support from appropriate internal colleagues, as necessary, and (iv) leading payor meetings
    • Sponsors and holds quarterly Joint Operating/Quality Committee (JOC/JQC) meetings with managed care payer leadership and key decision-makers to identify and pursue business growth opportunities, resolve key clinical and/or operational issues, etc.
    • Sponsors quarterly cross-divisional, cross-functional Managed Care meetings (a forum for communication between the market’s key internal constituents) to assess key managed care trends, and to inform and adjust market-based managed care strategies and contract initiatives, as necessary
    • Educate core group of market operators and other internal support services (e.g. Business Office, Admission, Sales & Marketing, Medical Management, etc.) on relevant elements of new or renegotiated contracts
    • Updates and maintains payor-specific activity for assigned accounts
    • Documents critical reporting capabilities for General Health System based on payors’ evolving data needs, as identified in JQC and other meetings
    Job Requirement
    Minimum of 5-7 years in the healthcare industry dealing directly with managed care activity, contract development or other consulting/public experience.
    3 to 5 years' experience directly related to the job duties noted in the job description.
    Experience in hospital administration or management with significant involvement with medical staff, patient relations, and incident management.
    Education Requirements:
    Bachelor’s degree in Business Administration, Nursing, Law or paralegal or related field
  • 21 Days Ago

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Managed Care Associate / Baton Rouge
  • Ascent Health, Inc.
  • Baton Rouge, LA FULL_TIME
  • Ascent Health, Inc. Location: Baton Rouge, LA Managed Care Associate The Managed Care Associate plays a vital role in tracking daily clinical operations within our organization. This position involves...
  • 23 Days Ago

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Medicaid Program Manager 3(Managed Care Compliance Manager)
  • State of Louisiana
  • Baton Rouge, LA OTHER
  • The Louisiana Department of Health is dedicated to fulfilling its mission through direct provision of quality services, the development and stimulation of services of others, and the utilization of av...
  • 2 Days Ago

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Memory Care Program Coordinator
  • Holly Court Assisted Living & Memory Care
  • Baton Rouge, LA FULL_TIME
  • Holly Court Assisted Living and Memory Care At Holly Court Assisted Living and Memory Care , we believe that everyone should be treated with respect. Our inclusive environment allows our diverse team ...
  • 23 Days Ago

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Memory care coordinator
  • Holly Court Assisted Living & Memory Care
  • Baton Rouge, LA FULL_TIME
  • Holly Court Assisted Living and Memory Care At Holly Court Assisted Living and Memory Care , we believe that everyone should be treated withrespect. Our inclusive environment allows our diverse team t...
  • 15 Days Ago

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Front Desk Receptionist/Patient Care Coordinator
  • HOOD DENTAL CARE
  • Denham Springs, LA FULL_TIME
  • Hood Dental Care is growing and looking to add passionate, professionals to our team! We are looking for someone who is upbeat, positive, passionate, and a team player. Prior Dental office experience ...
  • Just Posted

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0 Managed Care Coordinator jobs found in Baton Rouge, LA area

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Medical Assistant 1 - Thoracic Surgery
  • Franciscan Missionaries of Our Lady Health System
  • Baton Rouge, LA
  • Job Description The Medical Assistant 1 assists in examination and treatment of patients under the direction of a physic...
  • 3/28/2024 12:00:00 AM

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Supv-RN Operations Coord- Ochsner Baton Rouge Emergency Medicine- Full Time Day Shift
  • Ochsner Health
  • Baton Rouge, LA
  • Job Description We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our comm...
  • 3/28/2024 12:00:00 AM

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Admissions Counselor/ Atlanta
  • Louisiana State University
  • Baton Rouge, LA
  • All Job Postings will close at 12:01a.m. CST (1:01a.m. EST) on the specified Closing Date (if designated). If you close ...
  • 3/28/2024 12:00:00 AM

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URGENT: Lead Electrical Engineer, PE
  • Planate Management Group
  • Baton Rouge, LA
  • Planate Management Group (PMG) is a Service-Disabled Veteran-Owned Small Business (SDVOSB) headquartered in Alexandria, ...
  • 3/28/2024 12:00:00 AM

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BR, Manager of Development
  • The Lighthouse for The Blind in New Orleans
  • Baton Rouge, LA
  • Job Type Full-time Description Under the direction of the Vice President of Development and Communications, and located ...
  • 3/27/2024 12:00:00 AM

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Direct Support Professional
  • Sevita
  • Baton Rouge, LA
  • D&S Community Services, a part of the Sevita family, provides community-based services for individuals with intellectual...
  • 3/26/2024 12:00:00 AM

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Gastroenterology Associates - Registered Nurse
  • GI Alliance
  • Baton Rouge, LA
  • Job Description Job Description GI Alliance is seeking an experienced Registered Nurse. Duties of this position include,...
  • 3/25/2024 12:00:00 AM

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Nurse Practitioner - PRN
  • Open Health Care Clinic
  • Baton Rouge, LA
  • Job Description Job Description Job Purpose: The Nurse Practitioner functions as an independent healthcare provider who,...
  • 3/25/2024 12:00:00 AM

Baton Rouge (/ˌbætən ˈruːʒ/ BAT-ən ROOZH; from French bâton rouge [bɑtɔ̃ ʁuʒ] (listen), meaning 'red stick') is the capital of the U.S. state of Louisiana. Located on the eastern bank of the Mississippi River, it is the parish seat of East Baton Rouge Parish, the most populous parish in Louisiana. It is the 99th most populous city in the United States, and second-largest city in Louisiana after New Orleans. It is also the 16th most populous state capital. As of the U.S. Census Bureau's July 2017 estimate, Baton Rouge had a population of 227,549, down from 229,493 at the 2010 census. Baton Rou...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$46,626 to $80,020
Baton Rouge, Louisiana area prices
were up 1.2% from a year ago

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Assist with on-boarding and training of new Managed Care Coordinators.
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