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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Position Base
Oakland
Location
UCOP - Franklin Building
UC OFFICE OF THE PRESIDENT
At the University of California (UC), your contributions make a difference. A world leader producing Nobel and Pulitzer prize recipients with over 150 years of groundbreaking research transforming the world. Choose a career where you can leverage your knowledge, skills and aspirations to inspire and support some of the greatest minds in the world, and those who will follow in their footsteps. Working at the University of California is being part of a unique institution, and a vibrant and diverse community. At the University of California, Office of the President, we propel our mission through impactful work locally, in government centers and systemwide. We are passionate people, serving the greater good.
The University of California, one of the largest and most acclaimed institutions of higher learning in the world, is dedicated to excellence in teaching, research and public service. The University of California Office of the President is the headquarters to the 10 campuses, six academic medical centers and three national laboratories and enrolls premier students from California, the nation and the world.
DEPARTMENT OVERVIEW
UC Legal - Office of the General Counsel (UCL) provides legal services to the University, including representation, advice, research and training. We also provide legal opinions to the Board of Regents, administration, faculty, staff and others acting on the university's behalf. We report jointly to the Board of Regents and the President.
POSITION SUMMARY
Reporting to the Managing Counsel, Health Affairs, Privacy & Data Protection, the Principal Counsel - Managed Care provides primary legal support to the University's health enterprise on managed care issues. Duties include advising on material managed care transactions including high-impact health plan contracts with the University's medical centers as well as administrative contracts between health plans and the University's employer group or student health plans; providing strategic guidance on managed care issues including innovative payment methodologies; advising on managed care regulatory issues including Knox-Keene Act licensure and other requirements; and acting as the subject-matter expert on managed care issues including privacy and fraud and abuse laws involving health plans, as well as rules related to Accountable Care Organization and other innovation models. The position is relied on to represent institutional concerns persuasively to internal and external parties and serves as the lead legal counsel contact on managed care issues and interacts frequently with the members of the UC Procurement Services, UC Health, and Human Resources teams in the Office of the President, the medical center or campus teams responsible for managed care and employer group or student health plans, as well as medical center Chief Financial Officers.
The Principal Counsel - Managed Care should be a strategic thinker, an approachable adviser, and a strong relationship builder who thrives in a challenging environment and is clearly aligned with the University's and UCL's values.
Responsibilities
90% Core Legal Work
10% Leadership
Required Qualifications
Preferred Qualifications
Education: Advanced degree in related area is required
License/Certifications: Must be in good standing in the California State Bar or admitted within one year of employment. CURRENT ADMISSION IS STRONGLY PREFERRED. California's Registered In-House Counsel program is NOT available to University of California attorneys.
Travel Requirements: 10% Travel to medical centers, as needed
SPECIAL CONDITIONS
The person hired will be required to reside within California and report to work on-site at UC's Office of the President (UCOP) located in Oakland, CA on a regular basis. Current policy requires that a new employee work on-site at least two days a week on Tuesdays and Wednesdays ("anchor days"). In rare circumstances, approved by the General Counsel, candidates residing in or willing to relocate to California may be considered for a fully remote work arrangement.
SALARY AND BENEFITS
Job Title: Counsel 4
Job Code: 000201
Salary Grade: Grade 29
Payscale: $220,000 - $255,000, commensurate with experience
Full Salary Range: $165,200 - $333,800
The University of California, Office of the President, is required to provide a reasonable estimate of the compensation range for this role. This range takes into account the wide range of factors that are considered in making compensation decisions including but not limited to experience, skills, knowledge, abilities, education, licensure and certifications, and other business and organizational needs. It is not typical for an individual to be offered a salary at or near the top of the range for a position. Salary offers are determined based on final candidate qualifications and experience. The full salary range shows the growth potential for this position and the pay scale is the budgeted salary or hourly range that the University reasonably expects to pay for this position. Benefits: For information on the comprehensive benefits package offered by the University visit:
ADDITIONAL INFORMATION
HOW TO APPLY
Please be prepared to attach a cover letter and resume with your application.
APPLICATION REVIEW DATE
The first review date for this job is January 2, 2024. The position will be open until filled.
CONDITIONS OF EMPLOYMENT
Background Check Process: Successful completion of a background check is required for this critical position.
Smoke Free Work Environment: The University of California, Office of the President, is smoke & tobacco-free as of January 1, 2014.
As a condition of employment, you will be required to comply with the University of California , as may be amended or revised from time to time. Federal, state, or local public health directives may impose additional requirements.
EEO STATEMENT
The University of California, Office of the President, is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age or protected veteran status.
The University of California, Office of the President, strives to make this job board accessible to any and all users. If you have comments regarding the accessibility of our website or need assistance completing the application process, please contact us at: or email the Human Resource Department at: .
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