Managed Care Coordinator jobs in Evansville, IN

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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MDS/Care Plan Coordinator
  • Petersen Health Care
  • Benton, IL FULL_TIME
  • The Care Plan Coordinator is responsible for the timely and accurate completion of the MDS, assessment protocols, comprehensive assessment and the development of each resident's individual Plan of Care. He/she solicits information from an interdisciplinary team (including the resident and the resident's family), develops the care plan, informs the staff and implements the completed Plan of Care. He/she monitors and records the progress (or lack of progress) of each resident. The CPC observes resident care on a daily basis to ensure the implementation of the Plan of Care.

    Job Responsibilities

    Administrative Functions
    • Conduct and coordinate the development and completion of the resident assessment (MDS) in accordance with current rules, regulations, and guidelines that govern the resident assessment, including the implementation of RAPs and Triggers.
    • Must possess the ability to plan, organize, develop, implement, and interpret the programs, goals, objectives, policies and procedures, etc., that are necessary for providing quality care.
    • Maintain and periodically update written policies and procedures that govern the development, use, and implementation of the resident assessment (MDS) and care plan.
    • Must possess the ability to make independent decisions when circumstances warrant such action.
    • Perform administrative duties such as completing medical forms, reports, evaluations, studies, etc., as necessary.
    • Develop, implement, and maintain an ongoing quality improvement program for the resident assessment/care plans.
    • Must be knowledgeable of nursing and medical practices and procedures, as well as, laws, regulations, and guidelines that pertain to long-term care.
    • Participate in facility surveys made by authorized government agencies.
    Committee Functions
    • Act as Chairperson of the Interdisciplinary Care Plan Team.
    • Work with the Interdisciplinary Care Plan Team in developing a comprehensive resident assessment and care plan for each resident.
    • Serve on, participate in, and attend various other committees of the facility as required, and as appointed by the Administrator.
    • Provide written and/or oral reports of the resident assessment/care plan functions as requested or directed.
    Personnel Functions
    • Must possess leadership and supervisory ability and the willingness to work harmoniously with professional and non-professional personnel.
    • Must possess the ability to deal tactfully with personnel, residents, family members, visitors, government agencies/personnel and the general public.
    • Maintain an effective, friendly working relationship with health professionals, physician, consultants, and governmental agencies that may be involved in the resident assessment/care plan functions of the facility.
    • Meet with and solicit advice from department personnel concerning the resident assessment t/care plan functions of the facility.
    Nursing Care Functions
    • Conduct or coordinate the interviewing of each resident for the resident’s assessment.
    • Evaluate each resident's condition and pertinent medical data to determine any need for special assessment activities or a need to amend the admission assessment.
    • Schedule the resident assessment/care plan meetings and provide scheduled dates to team members
    • Contact and assist in scheduling participation by outside members of the care plan team, including the resident's representative and/or other interested family members.
    • Work with staff to ensure that care is provided in accordance with the resident's wishes.
    Staff Development
    • Assist in training activities needed concerning resident assessment/care plan skills.
    • Attend and participate in annual OSHA and CDC in-service training programs for hazard communication, TB management, and bloodbome pathogens standard.
    • Attend and participate in continuing education programs designed to help you keep abreast of changes in this profession, as well as to maintain your license on a current status.
    Care Plan and Assessment Function
    • Develop preliminary and comprehensive assessments of the nursing needs of each resident, utilizing the forms required by current rules or regulations and facility policies.
    • Ensure that appropriate health professionals are involved in the assessment.
    • Ensure that all members of the assessment team are aware of the importance of completeness and accuracy in their assessment functions.
    • Coordinate the development of a written plan of care for each resident that identifies the problems/needs of the resident, indicates the care to be given, goals to be accomplished, and which professional service is responsible for each element of care.
    • Ensure that the care plan includes measurable objectives and timetables to meet the resident's medical, nursing, and mental psychosocial needs as identified in the resident’s assessment.
    • Ensure that the initial, quarterly, significant change and annual resident assessments and are completed within required time frames.
    Resident Rights
    • Maintain the confidentiality of all resident care information.
    • Ensure that resident interviews are conducted in private.

    Required Skills and Qualifications

    • Be of legal working age
    • Be able to read and follow written directions
    • Be able to communicate with residents and co-workers in English
    • Must possess the ability to deal tactfully with personnel, residents, family members, visitors, government agencies/personnel and the general public.
    • Work overtime is necessary
    • Current license in good standing in the state in which the facility is located as a Licensed Practical Nurse or Registered Nurse
    • Must have a working knowledge of medical, pharmaceutical, psychological and social treatment, care and terminology.
    • This position requires general knowledge of physical, mental and psychosocial well-being in the elderly and the ability to integrate this information to develop an interdisciplinary Plan of Care.
  • 1 Month Ago

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Care Coordinator
  • Centerstone
  • Marion, IL FULL_TIME
  • Centerstone is among the nation's leading nonprofit behavioral health systems with thousands of employees dedicated to delivering care that changes people's lives. A dynamic, well-established organiza...
  • 17 Days Ago

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Mds coordinator
  • Petersen Health Care
  • Rosiclare, IL FULL_TIME
  • Responsibilities Administrative Functions Conduct and coordinate the development and completion of the resident assessment (MDS) in accordance with current rules, regulations, and guidelines that gove...
  • Just Posted

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Maintenance Coordinator
  • Petersen Health Care
  • Harrisburg, IL FULL_TIME
  • The Maintenance Person maintains all building, equipment, systems and grounds in good, safe and presentable condition. He/she conducts a preventative maintenance program for all mechanical, signal, fi...
  • 1 Day Ago

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Vendor Managed Inventory Specialist
  • MSC Industrial Supply Co.
  • Evansville, IN FULL_TIME
  • Build a better career with MSC. Serving customer and community starts with the very best people doing their very best work. That is precisely what we have at MSC Industrial Supply Co., a leading North...
  • 1 Month Ago

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Inpatient Care Coordinator
  • Global Placement Firm
  • Evansville, IN FULL_TIME
  • Patient types Geriatric Licenses and certifications CCM (Critical Care Management), State RN License Minimum education Associates or Bachelors Years’ experience 3 years Travel requirements Local trave...
  • 17 Days Ago

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0 Managed Care Coordinator jobs found in Evansville, IN area

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DSS RN III Float ED/OR - No Experience Required
  • Deaconess Health System
  • Henderson, KY
  • As a nurse at Deaconess, you will be a part of a caring, compassionate team, dedicated to exceptional patient care.# Dea...
  • 4/24/2024 12:00:00 AM

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Physical Therapist Home Care
  • Carle
  • Owensville, IN
  • The Home Care Physical Therapist evaluates and develops treatment plans for patients of all ages, modifying the plan of ...
  • 4/24/2024 12:00:00 AM

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Licensed Therapist
  • Eventus WholeHealth
  • Evansville, IN
  • Job Description Job Description Position Summary: Eventus WholeHealth delivers an integrated model of care to adults who...
  • 4/23/2024 12:00:00 AM

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Registered Nurse (RN) - Days
  • Brentwood Springs
  • Newburgh, IN
  • Overview: Registered Nurse Check out our differentials! $3 weekday evening $5 weekday night $5 weekend day $7 weekend ni...
  • 4/22/2024 12:00:00 AM

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Home Health Aide
  • Better Living Home Health Care, Inc
  • Evansville, IN
  • We have Immediate Openings for the best Licensed Home Health Aides and Certified Nursing Aides in your area!! We current...
  • 4/22/2024 12:00:00 AM

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System Director of Case Management
  • Deaconess Health System
  • Evansville, IN
  • Join Our Team# We are looking for compassionate, caring, and dedicated System Director of Case Management to join our te...
  • 4/22/2024 12:00:00 AM

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LPN Home Care
  • Caretenders - Owensboro Waiver
  • Owensboro, KY
  • We are now hiring an LPN for Private Duty Home Care in Whitesville, KY. 8 hour days (7 AM-3 PM) or evenings (3 PM-11 PM)...
  • 4/9/2024 12:00:00 AM

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LPN Home Care Weekly Pay
  • Caretenders - Owensboro Waiver
  • Lewisport, KY
  • We are now hiring an LPN for Private Duty Home Care in Lewisport, KY. 8 hour days (7 AM-3 PM) or evenings (3 PM-11 PM) s...
  • 4/9/2024 12:00:00 AM

Evansville is a city and the county seat of Vanderburgh County, Indiana, United States. The population was 117,429 at the 2010 census, making it the state's third-most populous city after Indianapolis and Fort Wayne, the largest city in Southern Indiana, and the 232nd-most populous city in the United States. It is the commercial, medical, and cultural hub of Southwestern Indiana and the Illinois-Indiana-Kentucky tri-state area, home to over 911,000 people. The 38th parallel crosses the north side of the city and is marked on Interstate 69. Situated on an oxbow in the Ohio River, the city is of...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$46,699 to $80,142
Evansville, Indiana 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.
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Managed Care Coordinator in Orange, CA
Assist with on-boarding and training of new Managed Care Coordinators.
January 20, 2020