Managed Care Coordinator jobs in Green Bay, WI

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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RN Care Manager
  • Managed Health Services Wisconsin
  • Carlton, WI FULL_TIME
  • You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. * We are currently offering a $5,000 sign-on bonus for this position * ** This hybrid remote role requires less than 50% travel in Milwaukee / Appleton area and candidates will have the flexibility to work remotely from their home the remaining time ** Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients • Provide patient and provider education • Facilitate member access to community based services • Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan • Actively participate in integrated team care management rounds • Identify related risk management quality concerns and report these scenarios to the appropriate resources. • Case load will reflect heavier weighting of complex cases than Care Manager I, commensurate with experience • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems • Direct care to participating network providers • Perform duties independently, demonstrating advanced understanding of complex care management principles. • Participate in case management committees and work on special projects related to case management as needed Education/Experience: Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred. 2 years of clinical nursing experience in a clinical, acute care, or community setting and 1 years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs.Licenses/Certifications: Current state’s RN license and a valid driver's license Pay Range: $66,100.00 - $118,900.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

    About the Company:
    Managed Health Services Wisconsin



  • 1 Month Ago

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Resident Care Coordinator
  • Priority Life Care
  • Lanse, MI FULL_TIME
  • At Priority Life Care (PLC), we provide you the opportunity to use your talents in a progressive, growing organization that makes a positive difference in the lives of the seniors we serve. If you are...
  • 10 Days Ago

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Patient Care Coordinator
  • Amenity Dental Care
  • Green, WI FULL_TIME,PART_TIME
  • About us Amenity Dental Care is a private, family dental practice in Green Bay, WI. Our mission is to provide outstanding care to our family of patients in a family-oriented, positive atmosphere. Our ...
  • 14 Days Ago

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Care Coordinator
  • Family Services of Northeast Wisconsin Inc.
  • Green, WI FULL_TIME
  • Are you ready to work for an employer who cares about your wellbeing? Family Services cares about their team and in addition to their excellent benefit package, they are now offering a staff sabbatica...
  • 1 Month Ago

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Resident Service Coordinator
  • Champion Care
  • Laona, WI PART_TIME
  • EXCELLENT OPPORTUNITY TO JOIN A GREAT TEAM! NU-ROC Health and Rehabilitation is looking for a highly motivated and energetic candidate, Typical duties for admissions coordinators include: Ensuring the...
  • 1 Day Ago

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Vendor Managed Inventory Associate
  • VALUE ADDED DISTRIBUTORS, LLC
  • De Pere, WI FULL_TIME
  • Value Added Distributors is looking for a driven, hardworking, and enthusiastic Vendor Managed Inventory (VMI) Associate to join our team in De Pere, WI! This position would mainly be responsible for ...
  • 1 Month Ago

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0 Managed Care Coordinator jobs found in Green Bay, WI area

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Family Resource Navigator & Resource Specialist (Part-time)
  • Family Services of Northeast Wisconsin Inc.
  • Menasha, WI
  • Family Services is a non-profit organization that protects, heals and cares for children and families throughout Northea...
  • 4/26/2024 12:00:00 AM

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Pharmacy Technician, Telehealth English/Hmong Bilingual-Remote
  • Navitus
  • Appleton, WI
  • Putting People First in Pharmacy- Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) mo...
  • 4/26/2024 12:00:00 AM

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CMA/LPN/EMT- UW Health Pediatric Cardiology- Allouez
  • Prevea Health
  • Green Bay, WI
  • New hires may be eligible for a sign on bonus up to $2500.00 for full time position/$1500.00 for part time positions. Pl...
  • 4/26/2024 12:00:00 AM

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CMA/LPN/EMT- Specialty (Surgery, Nephrology, Urology, GI) - Green Bay area Float- Part time
  • Prevea Health
  • Green Bay, WI
  • New hires may be eligible for a sign on bonus up to $2500.00 for full time position/$1500.00 for part time positions. Pl...
  • 4/26/2024 12:00:00 AM

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staff - Level I Registered Nurse (RN) - Cardiology - $32-52 per hour
  • Adventist Health
  • Green Bay, WI
  • Advocate Aurora Health is seeking a Registered Nurse (RN) Cardiology Level I for a nursing job in Green Bay, Wisconsin. ...
  • 4/24/2024 12:00:00 AM

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LPN Private Duty Pediatrics
  • LHC Group
  • Menasha, WI
  • Job Description We are hiring a Private Duty Licensed Practical Nurse in the Kiel / New Holstein area to travel to schoo...
  • 4/22/2024 12:00:00 AM

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Hospice Registered Nurse
  • Heartland Hospice
  • DePere, WI
  • Our Company: Heartland Hospice is a member of the Gentiva family - an industry leader in hospice, palliative, home healt...
  • 4/11/2024 12:00:00 AM

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LPN Private Duty Weekly Pay
  • Almost Family
  • Chilton, WI
  • We are hiring Private Duty Licensed Practical Nurses and Homecare Visit LPNs in Chilton and Kiel. We have part-time, and...
  • 3/27/2024 12:00:00 AM

Green Bay is a city in and the county seat of Brown County in the U.S. state of Wisconsin, at the head of Green Bay, a sub-basin of Lake Michigan, at the mouth of the Fox River. It is 581 feet (177 m) above sea level and 112 miles (180 km) north of Milwaukee. The population was 104,057 at the 2010 census. Green Bay is the third-largest city in the state of Wisconsin, after Milwaukee and Madison, and the third-largest city on Lake Michigan's west shore, after Chicago and Milwaukee. Green Bay is home to the National Football League's Green Bay Packers. Green Bay is the principal city of the Gree...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$46,994 to $80,649
Green Bay, Wisconsin 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