Managed Care Coordinator jobs in Columbus, MS

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

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Care Coordinator
  • North Mississippi Medical Center System
  • Tupelo, MS FULL_TIME
  • Tupelo
    CASE MANAGEMENT
    Full Time - Day

    Posting Description


    At North Mississippi Health Services, our mission is to “continuously improve the health of the people of our region.” Our vision is to “provide the best patient and family-centered care and health services in America.” We believe that fulfilling our mission and vision calls us to embrace the best people that form incredible connections to our patients and families. We take pride in celebrating everything that makes you uniquely you – your talents, your perspectives, and your passions. At North Mississippi Health Services, we believe in connecting your passion with a purpose. When you are part of our team, you know what connected feels like. #WhatConnectsYou

    Job Description


    **JOB SUMMARY** The Coordinator - Care RN at North Mississippi Health Services is responsible for conducting patient assessments to determine their needs and barriers to disease management or recovery. They implement interventions, monitor the effectiveness of care plans, and coordinate transition of care to post-acute services. The Coordinator educates patients and family members on the provided services and collaborates with various healthcare professionals to ensure effective patient care. **JOB FUNCTIONS** Coordinates:  • Conducts assessment to determine patient needs and barriers to disease management of continued recovery  • Implements appropriate interventions to address identified patient needs and maintain regulatory requirements  • Monitors the effectiveness of the patient’s care plan and intervenes when necessary to address potential     progression delays  • Arranges appropriate post-acute services and procurement of durable medical equipment  • Coordinates transition of care as indicated  • Assess the discharge planning needs of the neonate, pediatric, adolescent, adult and geriatric patient Reporting:  • Documents assessment findings and interacts in the clinical record according to establish standards  • Performs cost/benefit analysis to determine most cost effective care  • Documents type education received by the patient and/or family members Education:  • Educates patient and/or family member(s) to the processes and services provided  • Attend and provide continuing education in-services  • Participates in performance improvement projects, committees, and teams Communicates:  • Communicates patient needs to appropriate sources such as Physicians, medical staff, DME Companies, Home Health and Hospice Staff,  and Nursing Home and Rehabilitation Facilities  • Communicates effectively with adult and geriatric patient   • Participates on committees and Physician Section meetings as requested/required Quality Improvement:  • Participates in QI initiates and other Hospital performance improvement programs Regulation:  • Adheres to NMHS/NMMC Policies/Procedures/Guidelines  • Complies with appropriate Local/State/Federal policies/procedures/guideline/regulations/laws/statues **Remote Work Capable** ? **QUALIFICATIONS** **Education** Education Level Education Details Required/ Preferred Associate's Degree with 3 years nursing, social work or counseling experience Required or Bachelor's Degree in Nursing, Social Work, or Counseling Required and Master's Degree Preferred **Licenses and Certifications** Licenses/Certifications Licenses/Certification Details Time Frame Required/ Preferred RN  - Registered Nurse - State Licensure and/or Compact State Licensure Upon Hire Required or LMSW  - Licensed Medical Social Worker - State Licensure Upon Hire Required or LPC-Licensed Professional Counselor Upon Hire Required Certified as a Board Certified Case Manager within 1 year of accepting position Upon Hire Preferred and Cardiopulmonary Resuscitation (CPR) Certified in Cardiopulmonary Resuscitation (CPR) Upon Hire Required **Work Experience** Experience Experience Details Required/ Preferred **Knowledge, Skills and Abilities** KSAs Proficiency Excellent organizational and communication (written and verbal) skills; required Knowledgeable in the documentation of social/work case management intervention methods; required Excellent interpersonal skills; required Demonstrated knowledge in the following areas:  pediatrics, adolescents, adults, and geriatrics Participate in Best Practice Models for care transitions Demonstrates positive leadership with Physicians, insurance companies, industry representatives and all other persons or entities within our service area Embraces the Mission, Vision, Values and Critical Success Factors of our organization Represents NMMC in a positive, professional manner Must have extensive contact with: Medical Staff, Nursing Personnel, DME Providers, Home Health Agencies, Community Agencies, referral resource providers, Utilization Review Manager, patients, and family members Must have excellent written and verbal communication skills Must project a positive, caring attitude toward clients, patients, staff and the public we serve

    Requirements:


    Licenses

    You must have the following licenses to apply:
    Licensed Social Worker

    Education

    You must have the following education to apply:
    Associates
  • 13 Days Ago
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C
Staffing Coordinator
  • Consulate Health Care
  • Meridian, MS FULL_TIME
  • Looking for qualified Staffing Coordinators to join our team! We are searching for a Staffing Coordinator to join our community that is patient and employee focused, a team builder, and excited about ...
  • 1 Day Ago
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Staffing Coordinator
  • Family Resource Home Care
  • Winfield, AL FULL_TIME
  • Are you seeking a rewarding career where you play a crucial role in improving lives? This position not only provides the chance to make a positive impact but also offers the flexibility of working fro...
  • 1 Month Ago
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C
Human resource coordinator
  • Consulate Health Care
  • Winona, MS FULL_TIME
  • Looking for qualified Human Resources Coordinators (HRC) to join our team! We are searching for a Human Resources Coordinator to join our community that is employee focused, a team builder, and excite...
  • 13 Days Ago
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C
Human Resources Coordinator
  • Consulate Health Care
  • Winona, MS FULL_TIME
  • Looking for qualified Human Resources Coordinators (HRC) to join our team! We are searching for a Human Resources Coordinator to join our community that is employee focused, a team builder, and excite...
  • 17 Days Ago
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C
RN MDS Coordinator
  • Consulate Health Care
  • Winona, MS FULL_TIME
  • Looking for qualified RN MDS Coordinators to join our team! You will have flexibility to build your schedule, a competitive base salary, lucrative employee referral program, opportunity for growth, pl...
  • 2 Days Ago
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0 Managed Care Coordinator jobs found in Columbus, MS area

A
Endodontist Columbus, MS- Part-time
  • Aspen Dental
  • Columbus, MS
  • At Aspen Dental, we put you first, so you can take your career to new heights. Our best-in-class learning and developmen...
  • 4/23/2024 12:00:00 AM
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RN - GT Starkville Infusion Center(7:45AM-4:15PM) BMH GTR
  • Baptist Memorial
  • Columbus, MS
  • Summary Coordinates and provides care utilizing the critical thinking framework known as the nursing process. The nursin...
  • 4/23/2024 12:00:00 AM
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A
Home Care Marketing Associate
  • A First Name Basis
  • Columbus, MS
  • Job Description Job Description A First Name Basis is a leading home care agency dedicated to providing quality care to ...
  • 4/23/2024 12:00:00 AM
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Internal Revenue Agent (Senior Revenue Agent (Examiner) -12 MONTH ROSTER
  • Department Of The Treasury
  • Columbus, MS
  • Duties WHAT IS THE SBSE - SMALL BUSINESS SELF EMPLOYED DIVISION? A description of the business units can be found at: ht...
  • 4/22/2024 12:00:00 AM
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Coordinator-Customer Service - MG Columbus Cardio Care
  • Baptist Memorial
  • Columbus, MS
  • Summary Promotes a high level of customer satisfaction during patient interactions, requiring knowledge of departmental ...
  • 4/22/2024 12:00:00 AM
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Supervisory Transportation Security Officer
  • Department Of Homeland Security
  • Columbus, MS
  • Summary Securing Travel, Protecting People - At the Transportation Security Administration, you will serve in a high-sta...
  • 4/22/2024 12:00:00 AM
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P
Behavioral Health Counselor - LCSW or LPC
  • Pathway Healthcare
  • Columbus, MS
  • Job Description Job Description POSITION ROLE The Behavioral Health Counselor’s role is to provide best in class behavio...
  • 4/21/2024 12:00:00 AM
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B
Intern-Nurse II - GT Nursery BMH GTR
  • Baptist Memorial
  • Columbus, MS
  • Summary Coordinates with physicians, physician office staff, ancillary departments and surgery staff to provide a patien...
  • 4/21/2024 12:00:00 AM
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About Columbus, Mississippi

The city is located approximately 10 mi (16 km) west of the Mississippi-Alabama state line along U.S. Route 82, U.S. Route 45, and numerous state highways. US 82 leads southeast 29 mi (47 km) to Reform, Alabama and west 25 mi (40 km) to Starkville. US 45 leads south 32 mi (51 km) to Macon and north 28 mi (45 km) to Aberdeen. According to the United States Census Bureau, the city has a total area of 22.3 square miles (57.8 square kilometers), of which 21.4 square miles (55.5 square kilometers) is land and 0.9 square miles (2.3 square kilometers) is water. Large lakes and rivers are nearby, such...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$42,019 to $72,111
Columbus, Mississippi area prices
were up 1.2% from a year ago
View detail

What does a Managed Care Coordinator do?

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