Managed Care Coordinator jobs in Gastonia, NC

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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Managed Care Analyst / Managed Care / Full-Time
  • Catawba
  • Claremont, NC FULL_TIME
  • Summary: 


     
    Position is responsible for working with various internal and external customers regarding contract payor terms, policy/procedure updates, payor administration, variances/contract modifications, pricing updates, as well as anything that has an operational impact on the organization.  Strong analytical skills needed to compile and analyze data including: managed care denials/underpayment/ overpayment identification and resolution, contract modeling and evaluation, filing appeals as well as aiding in decision support reporting.  This position is responsible for day-to-day oversight of the contract compliance, payor relationships, co-ordination of payer onsite meetings and cross training with Provider Enrollment Specialist for credentialing and re-credentialing duties. Must work within contract language and have an understanding of healthcare reimbursement methodologies and language.  Majority of time will be spent working within Microsoft Excel, performing data analysis, tracking, trending and research.  Will also work with Contract Modeling software. 

     
    Required Education: 

     
    Associate’s degree from an accredited college or a minimum of four years’ experience with managed care contracting or payor relations. 

     
    Required Work Experience: 

     
    One year of applicable experience, if candidate has no experience they must have completed a successful healthcare or finance oriented internship with good references or an extensive managed care or an analytical background.  
  • 1 Month Ago

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Client Care Coordinator/RN
  • Comfort Keepers Home Care
  • Shelby, NC PART_TIME
  • Are you looking for a career where you can use your results-driven expertise to fulfill your passion of making a difference in the lives of seniors? Do you love building and maintaining working relati...
  • 9 Days Ago

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IT Account Executive
  • ICS Managed IT Services
  • Gastonia, NC FULL_TIME
  • We are seeking an IT Account Executive to join our team! You will resolve customer questions and offer solutions to drive company revenue. Responsibilities: Present and sell company products and servi...
  • 29 Days Ago

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IT Help Desk Technician
  • ICS Managed IT Services
  • Gastonia, NC FULL_TIME
  • We are seeking an IT Help Desk Technician to join our team! This position is an in-office help desk technician that assists clients with technical needs as well as serve on a team for on-boarding new ...
  • 30 Days Ago

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Program Coordinator
  • Higher Learning Child Care Academy, Inc.
  • Kings Mountain, NC FULL_TIME
  • Exciting Opportunity: Program Coordinator Position at Higher Learning Child Care Academy, Inc.! CORE Values: Family, Fun, Integrity, Innovation, Teamwork, Thankfulness (F.I.T.) Are you passionate abou...
  • 24 Days Ago

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Resident Care Coordinator
  • Brookdale Hickory Northeast
  • Hickory, NC FULL_TIME
  • Overview Voted by Newsweek in 2024 as one of America's Greatest Workplaces for Diversity The Resident Care Coordinator provides direct supervision of care giving within the community. Ensures resident...
  • 17 Days Ago

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0 Managed Care Coordinator jobs found in Gastonia, NC area

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Licensed Therapist
  • Eventus WholeHealth
  • Gastonia, NC
  • 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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Patient Care Coordinator
  • Levine Hearing
  • Charlotte, NC
  • Job Description Job Description Full Job Description Levine Hearing is an independent Audiology practice that focuses on...
  • 4/22/2024 12:00:00 AM

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Habilitation Manager
  • BAYADA
  • Hickory, NC
  • Description BAYADA Home Health Care has an immediate opening for a Habilitation Manager (Qualified Professional) in our ...
  • 4/21/2024 12:00:00 AM

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Licensed Practical Nurse Home Health Full Time
  • Kindred At Home
  • Gastonia, NC
  • As a Home Health LPN, you will: Provide professional nursing services under the direction of a RN in compliance with the...
  • 4/21/2024 12:00:00 AM

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Addiction Counselor-LI (Remote Opportunity)Telehealth Behavioral Health
  • Nyc Health + Hospitals
  • Charlotte, NC
  • About NYC Health + Hospitals: Lincoln Medical and Mental Health Center is one of New York Citys premier acute care hospi...
  • 4/20/2024 12:00:00 AM

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Addiction Counselor-LI (Remote Opportunity)Telehealth Behavioral Health
  • NYC Health + Hospitals
  • Charlotte, NC
  • About NYC Health + Hospitals: Lincoln Medical and Mental Health Center is one of New York City’s premier acute care hosp...
  • 4/19/2024 12:00:00 AM

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Tailored Care Management Extender
  • Phoenix Counseling & Crisis Centers
  • Gastonia, NC
  • Job Description Job Description General Position Description: The primary responsibilities of the Behavioral Health Care...
  • 4/19/2024 12:00:00 AM

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Licensed Practical Nurse Home, Health Full Time
  • CenterWell Home Health
  • Gastonia, NC
  • Become a part of our caring community and help us put health first As a Home Health LPN, you will: Provide professional ...
  • 4/19/2024 12:00:00 AM

Gastonia is the largest city in and county seat of Gaston County, North Carolina, United States. It is also the second largest satellite city of the Charlotte area, behind Concord. The population was 71,741 at the 2010 Census. In 2016, the population had increased to 75,536. Gastonia is the 13th largest city in North Carolina. It is part of the Charlotte metropolitan area, officially designated the Charlotte Metropolitan Statistical Area (MSA). Gastonia has experienced steady growth, with a population increase between 2000 and 2010 of nearly 8.2%, according to the U.S. Census Bureau. According...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$47,733 to $81,917
Gastonia, North Carolina 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