Managed Care Coordinator jobs in Miami, FL

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
  • Miami, FL 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.
  • 1 Month Ago

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Financial Specialist, Managed Care
  • Independent Living Systems
  • Miami, FL FULL_TIME
  • ABOUT USJoin us in making a career in Independent Living Systems, an industry leader in managing home and community-based programs for over 20 years. Independent Living Systems, LLC and its subsidiari...
  • 1 Month Ago

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Director of Managed Care Contracting
  • Sanitas
  • Doral, FL OTHER
  • Job Details Job Location: Miami Dade - Corporate - Doral, FL Salary Range: Undisclosed DescriptionJob Overview: The Director of Managed Care Contracting is accountable for achieving financial and busi...
  • 1 Month Ago

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Senior Director of Managed Care Contracting
  • Sanitas
  • Doral, FL OTHER
  • Job Details Job Location: Miami Dade - Corporate - Doral, FL Salary Range: Undisclosed DescriptionJob Overview: The Director of Managed Care Contracting is accountable for achieving financial and busi...
  • 25 Days Ago

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Linkage to Care Coordinator
  • Care Resource
  • Miami, FL FULL_TIME
  • Essential Job Responsibilities Care Coordination and Caseload Management Provides care coordination to Miami/Fort Lauderdale area minorities using program methodology. Identifies and serves clients wh...
  • 8 Days Ago

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Dental Care Referrals Coordinator
  • Care Resource
  • Miami, FL FULL_TIME
  • Essential Job Responsibilities Administrative Duties Processes specialty referrals for patient visits including in-house specialists and outside providers via insurance portals, phone calls etc. Ensur...
  • 27 Days Ago

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0 Managed Care Coordinator jobs found in Miami, FL area

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Patient Care Coordinator - Call Center
  • Stratford Medical Group
  • Fort Lauderdale, FL
  • Job Description Job Description Job Summary Looking for self-motivated and dependable individuals with customer service ...
  • 4/22/2024 12:00:00 AM

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Care coordinator
  • ChenMed
  • Fort Lauderdale, FL
  • **Were unique. You should be, too.** Were changing lives every day. For both our patients and our team members. Are you ...
  • 4/21/2024 12:00:00 AM

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Home Health Care Coordinator
  • RightHIRE Staffing Solutions,
  • Pinecrest, FL
  • Job Description Job Description We are seeking to hire a care coordinator / HR agent who will work on-site in the Main O...
  • 4/21/2024 12:00:00 AM

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Patient Care Coordinator
  • Chirocare Of Florida Holdings Llc
  • Fort Lauderdale, FL
  • Job Description Job Description Job Description: We are looking for an upbeat, energetic, experienced, Patient Coordinat...
  • 4/20/2024 12:00:00 AM

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Patient Care Coordinator
  • Team Post-Op, Inc.
  • Sunrise, FL
  • Job Description Job Description Looking for a Full-Time employee to begin immediately. Tasks include making outbound pat...
  • 4/20/2024 12:00:00 AM

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Care Coordinator
  • Sanitas
  • Homestead, FL
  • Job Details Job Location Miami Dade - Homestead - Homestead, FL Education Level 4 Year Degree Job Shift Day Job Category...
  • 4/19/2024 12:00:00 AM

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Remote LPN Patient Care Coordinator
  • Wellbox, Inc.
  • Miami, FL
  • Description Wellbox is a growing healthcare company dedicated to helping people live healthier, happier lives. We do thi...
  • 4/19/2024 12:00:00 AM

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Care Coordinator
  • Sanitas
  • Miami, FL
  • Job Details Job Location Miami Dade - Palmetto Bay - Miami, FL Education Level 4 Year Degree Job Shift Day Job Category ...
  • 4/18/2024 12:00:00 AM

Miami, officially the City of Miami, is the cultural, economic and financial center of South Florida. Miami is the seat of Miami-Dade County, the most populous county in Florida. The city covers an area of about 56.6 square miles (147 km2), between the Everglades to the west and Biscayne Bay on the east; with a 2017 estimated population of 463,347, Miami is the sixth most densely populated major city in the United States. The Miami metropolitan area is home to 6.1 million people and the seventh-largest metropolitan area in the nation. Miami's metro area is the second-most populous metropolis i...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$47,536 to $81,579
Miami, Florida area prices
were up 2.9% 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