Managed Care Coordinator jobs in Columbus, GA

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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Coordinator
  • Abide Home Care
  • La Grange, GA FULL_TIME
  • Abide Home Care -

    After Hours Call Team (ACT) Coordinator

    Job Description

    Results inherent to this position (Position Statement)

    To help retain long-term quality clients and caregivers by effectively executing systems related to service inquiries, caregiver and client scheduling, after hours emergencies and other such systems that support the overall operations of Abide Home Care.

    Work Inherent In This Position

    1. Contributes to duties related to service inquiry calls including taking the initial service inquiry calls, sending information to appropriate Abide Home Care regional team and inputting information into the scheduling software.

    2. Responsible for handling and caregiver / client schedule changes by following the appropriate organizational chart for action steps.

    3. Responsible for the maintenance and accuracy of the scheduling system.

    4 . Responsible for reporting directly to the Abide ACT Lead on all the duties listed above on a weekly basis.

    5. Oversight of all office purchases, including all office supplies and other items.

    6. Responsible for coordinating all after hours scheduling activities with the caregivers and clients and tracking these updates and changes in the scheduling system.

    7. Responsible for taking initial client / caregiver emergency calls and client / caregiver complaints and reporting to the appropriate Abide Home Care regional team for further direction.

    General Standards

    1. All work will be orchestrated, documented and quantified toward the achievement of the company’s strategic objective.

    Orchestration means all routine activities will be documented and managed within the structure and context of the operations manual.

    All systems documentation will be formatted according to company templates.

    2. All work will be performed in accordance with all government laws, regulations, ordinances, and court rulings in those jurisdictions in which the company operates.

    3. All work will be performed according to company policies and standards inherent in all position contracts, action plans, employee manuals, ongoing policy memorandums, facilities and dress codes, as well as in the vision and spirit of the company’s strategic objective, company story and positioning statement.

    4. All client and employee materials and information will be held as strictly confidential outside the company. The information included in the operations manual is proprietary.

    5. All communication, both internal and external, will be returned within one business day and within two hours whenever possible.

    6. The Abide Regional Team (see company organizational chart) will be notified of any issues to be resolved or deadlines that cannot be met prior to the due date .

    7. All employee policy memorandums indicating changes in policy and / or procedure will be stored in each employee's manual until which time an updated procedure is provided.

    8. Employees will provide staff assistance as requested, with a spirit of helpfulness. This means each employee may be asked from time to time to cover in other areas of accountability and / or departments as a matter of exception, not routine.

    9. All business communications, whether verbal, visual or written, whether for internal or external use, will be professional in tone and content and according to any applicable and existing company policies and standards.

    10. Employees will respect each other’s time, space and need for concentration. Socializing and interruptions must not impede workflow.

    12. The ACT Lead will have weekly, regularly scheduled meetings with their director and / or Regional teams.

    13. Employees are encouraged to recommend ideas for the vision of the company, innovations and improvements within their department and position that are consistent with the company’s Strategic Objective.

    Innovation is encouraged and can be an ongoing process.

    04 / 27 / 2022 Company documentation is confidential and proprietary to GLAH, LLC.

    Required Qualifications

    1. Must be able to operate a computer, and software necessary to accomplish operations, including; scheduling programs, Microsoft Office Word and Excel, web browser and email.

    2. Must be able to communicate fluently and clearly, both verbally and in writing, in the language most commonly used in the workplace, which is English

    3. Must be able to meet attendance expectations, and meet deadlines.

    4. Must have a high school diploma.

    Preferred Qualifications

    1. Strong organizational, time management, and prioritization skills.

    2. Excellent communication skills and a positive attitude.

    3. Analytical and problem solving skills to take ownership and make competent decisions.

    4. Ability to work in a fast paced environment.

    5. Background in homecare, healthcare or scheduling.

    Last updated : 2024-03-28

  • 25 Days Ago

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MDS COORDINATOR – Long Term Care Facility
  • Care Network
  • La Grange, GA FULL_TIME
  • Job Purpose: To manage the RAI Process, adhering to Federal and State guidelines, and in accordance with company’s policies and procedures. Essential job Duties and Responsibilities: Manage Area or Pr...
  • 2 Days Ago

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Care coordinator
  • Aspire Behavioral Health & DD Services
  • Columbus, GA FULL_TIME
  • A. ORGANIZATIONAL RELATIONSHIPS Position Title : IC3 Care Coordinator Position Number : Work Unit : IC3 (Impact) Immediate Supervisor's Title : IC3 Wraparound Supervisor List positions supervised thro...
  • 2 Days Ago

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Bilingual Patient Care Coordinator
  • Ortho Sport and Spine Physicians
  • Auburn, AL FULL_TIME
  • Are you ready to begin a rewarding journey as a Patient Care Coordinator with Ortho Sport and Spine Physicians? We're searching for a compassionate and organized individual to join our exceptional cre...
  • 17 Days Ago

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Memory Care Coordinator
  • Brookside Glen
  • Columbus, GA FULL_TIME
  • We offer an unparalleled quality of life at all levels of retirement. We have created a community that allows our residents to do as much, or as little, as they like while offering the ability to age ...
  • 20 Days Ago

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Patient care coordinator
  • CenterWell Home Health
  • Columbus, GA FULL_TIME
  • Become a part of our caring community and help us put health first As a Patient Care Coordinator (Clinical Liaison), you will : Develop / maintain contact with key hospital, skilled nursing, assisted ...
  • Just Posted

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0 Managed Care Coordinator jobs found in Columbus, GA area

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RN-Case Mgr NE
  • St. Francis-Emory Healthcare
  • Columbus, GA
  • Description Under the general supervision of the Case Management Director, acts as a patient advocate/ Case Manager to h...
  • 4/25/2024 12:00:00 AM

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Speech Language Pathologist Home Health Full Time
  • CenterWell Home Health
  • Columbus, GA
  • Become a part of our caring community and help us put health first As a Home Health Speech Language Pathologist, you wil...
  • 4/25/2024 12:00:00 AM

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RN-Infection Control Practitioner
  • St. Francis-Emory Healthcare
  • Columbus, GA
  • Description At St. Francis-Emory Healthcare, we recognize that our patients deserve qualified, engaged, and competent he...
  • 4/25/2024 12:00:00 AM

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Registered Nurse
  • St. Francis-Emory Healthcare
  • Columbus, GA
  • Description At. St. Francis-Emory Healthcare, we know that achieving positive patient outcomes is only possible when the...
  • 4/25/2024 12:00:00 AM

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(PRN) RN Hospice (Columbus, GA.) ProHealth Home Health and Hospice
  • ProHealth Home Health & Hospice
  • Columbus, GA
  • JOB SUMMARY: To provide nursing care to the terminally ill Hospice patient as needed. To provide assistance and understa...
  • 4/24/2024 12:00:00 AM

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RN Clinical Assessment Advisor, Home Health
  • CenterWell Home Health
  • Columbus, GA
  • Become a part of our caring community and help us put health first The Clinical Assessment Advisor directly completes an...
  • 4/24/2024 12:00:00 AM

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Patient Care Coordinator, Home Health
  • CenterWell Home Health
  • Columbus, GA
  • Become a part of our caring community and help us put health first As a Patient Care Coordinator (Clinical Liaison), you...
  • 4/21/2024 12:00:00 AM

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Certified Home Health Registered Nurse (RN) - $58-61/Hr - Columbus, GA
  • ConnectRN
  • Columbus, GA
  • connectRN is an app created by a nurse, with nurses and aides' needs in mind. Every day, connectRN helps thousands of nu...
  • 4/21/2024 12:00:00 AM

Columbus is one of Georgia's three Fall Line Cities, along with Augusta and Macon. The Fall Line is where the hilly lands of the Piedmont plateau meet the flat terrain of the coastal plain. As such, Columbus has a varied landscape of rolling hills on the north side and flat plains on the south. The fall line causes rivers in the area to decline rapidly towards sea level. Textile mills were established here in the 19th and early 20th centuries to take advantage of the water power from the falls. Columbus was developed along the Chattahoochee River. Interstate 185 runs east of the city, with acc...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$43,793 to $75,154
Columbus, Georgia area prices
were up 1.5% 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