Managed Care Coordinator jobs in Houston, TX

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
  • Houston, TX 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 Payer Contracting
  • Texas Regional Physicians
  • Houston, TX FULL_TIME
  • DescriptionRESPONSIBILITY:Collaborate with leadership, identify appropriate contracting and re-contracting opportunities.Initiates discussions with key constituents as related to new relationships or ...
  • 1 Month Ago

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Managed Care Provider Relations Specialist
  • Curitec, LLC.
  • Spring, TX FULL_TIME
  • Overview: Curitec is seeking a skilled individual to join our team as a Managed Care Provider Relations Specialist. This role is pivotal in managing all aspects of contracting within our managed care ...
  • 8 Days Ago

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Managed Care Representative II - Member Services
  • Kelsey-Seybold
  • Pearland, TX FULL_TIME
  • Responsibilities Managed Care Representatives respond to inquiries from health plan members, providers and various customers while consistently meeting productivity, quality and service standards. Rep...
  • 28 Days Ago

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Senior Pharmacy Managed Care Contract Administrator - Payor Contracting
  • Texas Children's Hospital
  • Houston, TX OTHER
  • Job Summary We are searching for a Senior Pharmacy Managed Care Contract Administrator -- someone who works well in a fast-paced setting. In this position, you will analyze, negotiate, and implement P...
  • 1 Month Ago

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Warehouse Worker
  • Managed Staffing
  • Richmond, TX FULL_TIME
  • Laborer/Plant Wide Utility (US)" - $15.00/Hourly/W2 Rotational shift work 1st shift 7, AM to 3 , PM 2nd shift 3PM to 11PM 3rd shift 11PM to 7AM.Duties:- Load and unload packages from trucks or contain...
  • Just Posted

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0 Managed Care Coordinator jobs found in Houston, TX area

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Patient Care Coordinator
  • Pure Health Clinics
  • Houston, TX
  • About Us: At Pure Health Clinics, we are dedicated to providing exceptional healthcare services that prioritize the well...
  • 4/19/2024 12:00:00 AM

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Transitional Care Coordinator
  • Doctor's Choice Home Care & Hospice Texas
  • Houston, TX
  • Description: Summary of Essential Functions for the Position: The Transitional Care Coordinator (TCC) is a member of the...
  • 4/19/2024 12:00:00 AM

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Patient Care Coordinator
  • Texas Periodontal Associates Pllc
  • Houston, TX
  • Job Description Job Description Looking for a front desk/ treatment coordinator with proven skills to manage accounts re...
  • 4/19/2024 12:00:00 AM

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Care Coordinator RN
  • Catholic Health Initiatives
  • Houston, TX
  • **Overview** Baylor St. Lukes Medical Center is an internationally recognized leader in research and clinical excellence...
  • 4/19/2024 12:00:00 AM

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Patient Care Coordinator
  • AEG Vision
  • Sugar Land, TX
  • 16200 City Walk, Sugar Land, Texas 77479Eye Trends-Sugarland Town Patient Care Coordinators are responsible for providin...
  • 4/19/2024 12:00:00 AM

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Client Care Coordinator
  • Home Instead Magnolia
  • Magnolia, TX
  • Looking for an impactful and meaningful job? Home Instead is looking for a professional and compassionate Client Care Co...
  • 4/18/2024 12:00:00 AM

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Client Care Coordinator
  • Home Instead Magnolia
  • Magnolia, TX
  • Looking for an impactful and meaningful job? Home Instead is looking for a professional and compassionate Client Care Co...
  • 4/18/2024 12:00:00 AM

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Patient Care Coordinator
  • Plastic Surgery Clinic
  • Houston, TX
  • Job Description Job Description Seeking full-time Patient Care Coordinator (PCC) for a Plastic Surgery & Aesthetic pract...
  • 4/16/2024 12:00:00 AM

Houston is located 165 miles (266 km) east of Austin, 88 miles (142 km) west of the Louisiana border, and 250 miles (400 km) south of Dallas. The city has a total area of 627 square miles (1,620 km2); this comprises 599.59 square miles (1,552.9 km2) of land and 22.3 square miles (58 km2) covered by water. The Piney Woods are north of Houston. Most of Houston is located on the gulf coastal plain, and its vegetation is classified as temperate grassland and forest. Much of the city was built on forested land, marshes, swamp, or prairie and are all still visible in surrounding areas.[citation need...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$49,408 to $84,792
Houston, Texas area prices
were up 2.3% 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