Managed Care Coordinator jobs in Columbus, OH

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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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Columbus, OH FULL_TIME
  • We are currently seeking a skilled and motivated Pharmacist with expertise in Pharmacy Benefit Management (PBM) and Managed Care. In this pivotal role, you will be responsible for overseeing medication utilization, formulary management, and ensuring cost-effective pharmacy services. The ideal candidate will bring a deep understanding of managed care principles, a proactive approach to problem-solving, and a commitment to optimizing pharmacy outcomes within a managed care environment.

    Preferred Qualifications:
    PharmD degree from an accredited pharmacy program
    Previous experience in Pharmacy Benefit Management (PBM) or Managed Care
    Knowledge of formulary development and management
    State pharmacy license in good standing
    Strong analytical and data interpretation skills
    Excellent communication and negotiation abilities
    Familiarity with healthcare regulations and compliance standards
    Collaboration experience with healthcare providers, payers, and pharmaceutical manufacturers
    Proficiency in utilizing pharmacy management software and tools
    Active participation in relevant professional organizations
    Dedication to staying informed about industry trends and innovations

    Responsibilities:
    Collaborate with healthcare stakeholders to implement and optimize pharmacy benefit programs
    Conduct formulary reviews and assessments to ensure cost-effective and evidence-based medication choices
    Monitor and analyze pharmacy utilization trends, identifying opportunities for cost savings and improved patient outcomes
    Provide expertise in drug utilization management and prior authorization processes
    Stay informed about industry regulations, guidelines, and emerging trends in managed care pharmacy
    If you are a passionate and experienced pharmacist with a background in PBM or Managed Care, we invite you to join our dynamic team dedicated to advancing healthcare through innovative and cost-effective pharmacy solutions. Apply now to contribute to the future of managed care pharmacy.
  • 29 Days Ago

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Managed Care Biller - Atrium Centers
  • Atrium Centers
  • Columbus, OH FULL_TIME
  • Atrium Centers…Be a light…to all residents, their families and team members “Our mission is to serve as a bright light in the lives of our residents and families by delivering compassionate, quality c...
  • 5 Days Ago

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Salon Coordinator
  • Sport Clips - Coordinator - OH103
  • Pickerington, OH FULL_TIME
  • Job Title: ‍ ️ Salon Coordinator Extraordinaire Wanted at Sport Clips! Company: Sport Clips Location: Pickerington, OH About Us: Sport Clips is on the hunt for a dynamic and enthusiastic Salon Coordin...
  • 1 Month Ago

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Hospice - Care Coordinator
  • Transitions Care - Columbus, OH
  • Worthington, OH FULL_TIME
  • DescriptionOur people are the difference.Transitions Care is a leading hospice organization that has changed the hospice experience for patients, families, and team members. Imagine a healthcare compa...
  • 13 Days Ago

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Post-Acute Care Coordinator
  • Genesis Home Care
  • Columbus, OH FULL_TIME
  • Agency: Genesis Home Care Our culture and people are what set us apart from other post-acute care providers. We're dedicated to the growth and development of our team to set them up for success. We CA...
  • 16 Days Ago

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Registered Nurse- Care Coordinator
  • Central Ohio Primary Care Physicians,Inc
  • Westerville, OH FULL_TIME
  • Central Ohio Primary Care Physicians is seeking at Care Coordinator RN to join it's Case Management team. The Care Coordinator manages care for high risk, chronically and acutely ill patients by colla...
  • 4 Days Ago

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0 Managed Care Coordinator jobs found in Columbus, OH area

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Patient Service Representative - Care Coordinator
  • quantum-health
  • Dublin, OH
  • Description Now Hiring For May Classes! Starting Pay: Minimum $18.00 - Maximum $24.00 per/hour* Shift Differential: + $0...
  • 4/18/2024 12:00:00 AM

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Medical Assistant as Health Coach Care Coordinator
  • Prescribe Fit LLC
  • Columbus, OH
  • Job Description Job Description Engaging with our clients’ life story begins with their healthcare provider. Prescribe F...
  • 4/18/2024 12:00:00 AM

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Client Care Coordinator
  • Visiting Angels Columbus West
  • Columbus, OH
  • Want to make a difference every day? Like to solve puzzles? Have excellent Customer service abilities? Join Visiting Ang...
  • 4/17/2024 12:00:00 AM

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Transitional Care Coordinator
  • Wellbe Senior Medical
  • Westerville, OH
  • Job Summary: Why WellBe? WellBes Culture is Welcoming Be part of something important: Be part of pioneering a new way of...
  • 4/17/2024 12:00:00 AM

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Clinical Nurse & Informaticist
  • Andhealth
  • Columbus, OH
  • Full Time Columbus, OH AndHealth is a healthcare technology company created to help people reverse chronic disease.?We a...
  • 4/16/2024 12:00:00 AM

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Spiritual Care Coordinator - Chaplain
  • Interim HealthCare
  • Newark, OH
  • Our Spiritual Care Coordinators – Chaplains have been called to care when they’re needed most. As a member of our hospic...
  • 4/15/2024 12:00:00 AM

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Spiritual Care Coordinator - Chaplain
  • Hiring Now!
  • Newark, OH
  • Our Spiritual Care Coordinators Chaplainshave been called to care when theyre needed most. As a member of our hospice te...
  • 4/14/2024 12:00:00 AM

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Addiction Counselor-LI (Remote Opportunity)Telehealth Behavioral Health
  • NYC Health + Hospitals
  • Columbus, OH
  • About NYC Health + Hospitals: Lincoln Medical and Mental Health Center is one of New York City’s premier acute care hosp...
  • 4/14/2024 12:00:00 AM

The confluence of the Scioto and Olentangy rivers occurs just north-west of Downtown Columbus. Several smaller tributaries course through the Columbus metropolitan area, including Alum Creek, Big Walnut Creek, and Darby Creek. Columbus is considered to have relatively flat topography thanks to a large glacier that covered most of Ohio during the Wisconsin Ice Age. However, there are sizable differences in elevation through the area, with the high point of Franklin County being 1,132 ft (345 m) above sea level near New Albany, and the low point being 670 ft (200 m) where the Scioto River leaves...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$48,374 to $83,016
Columbus, Ohio area prices
were up 1.3% 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