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)
A fantastic career opportunity for Assistant Director of Managed Care and Contracting is now available with a prestigious healthcare system in Nevada!
The Assistant Director of Contracting and Managed Care will join a full-service community hospital, offering comprehensive medical, surgical and therapeutic services. The hospital provides innovative, technologically advanced care on a patient-friendly, easy-access campus and is very proud of the acclaim they receive for excellence in patient care and safety. They accomplished Excellence Award for Stroke Care and ranked in the top 10 percent in the nation for spine surgery.
The Assistant Director of Managed Care and Contracting will report directly to the Chief Executive Officer CEO and will be responsible to provide support to the Director in negotiating and managing contracts with healthcare providers and payers. The Assistant Director of Contracting and Managed Care will ensure contracts comply with legal and regulatory requirements and meets the organization’s financial and strategic goals.
The Assistant Director of Contracting and Managed Care will need to have knowledge of policies and procedures as they apply to Acute Care, Primary and Quick Care Units; managed care terminology; supervisory principles and practices; marketing principles and practices; Federal, state and county laws and regulations related to the health care agency; principles of contract law and methods and practices of drafting contracts and agreements; basic data sampling and statistical analysis techniques.
The Assistant Director of Managed Care and Contracting will carry assigned project(s) through from data gathering to completion, developing contractual relationship, negotiating contracts for services, maintaining accurate records and files, preparing clear and concise reports, communicating with a wide variety of people from diverse socio-economic and ethnic backgrounds, establishing and maintaining effective working relationships with all personnel contacted in the course of duties.
The ideal candidate for Assistant Director of Managed Care and Contracting should have a Bachelor’s Degree with Master's degree (healthcare administration, business administration, or a related field) preferred. Five years minimum of professional level experience in managed care/health care program management, contract preparation and management healthcare operations, financial management, and healthcare billing.
The Assistant Director of Managed Care and Contracting will have a family of healthcare professionals who not only enjoys outstanding benefits and professional growth opportunities, but also an environment noted for diversity, community involvement, intellectual excitement, artistic pursuits, and natural beauty. As an employee, you will enjoy generous benefits and work/life programs. Join the reputable team now!
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