Managed Care Coordinator jobs in Newark, NJ

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
  • Newark, NJ 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.
  • 8 Days Ago

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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Jersey, NJ 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 medicatio...
  • 8 Days Ago

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Copywriter/Content Marketer
  • First Managed Care Option, Inc.
  • Morris, NJ FULL_TIME
  • Company Overview First MCO is a full-service managed care organization providing medical cost containment services for workers’ compensation programs and auto insurers. First MCO is a dynamic and inno...
  • 14 Days Ago

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Patient Care Coordinator
  • Heart to Heart Home Care
  • East Orange, NJ FULL_TIME
  • Busy homecare agency located in central New Jersey seeking a Patient Care Coordinator to coordinate and manage patient cases. Candidates for the Patient Care Coordinator position must be quick learner...
  • 1 Month Ago

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Weekend On-call Client Care Coordinator
  • Life Home Care
  • Livingston, NJ PART_TIME
  • About us:Life is a growing company that has an innovative approach to Health Care. Our goal is to promote independence for our clients by providing compassionate care in the comfort of their homes.Lif...
  • 3 Days Ago

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Administrative Services Coordinator - Memory Care
  • ProMedica Senior Care
  • Whippany, NJ FULL_TIME
  • The Administrative Services Coordinator is responsible for human resources, accounts payable, accounts receivable, payroll, and general clerical duties. Because you are always in contact with resident...
  • 1 Month Ago

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0 Managed Care Coordinator jobs found in Newark, NJ area

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UM Care Coordinator
  • Centers Plan for Healthy Living
  • Staten Island, NY
  • UM Care Coordinator Staten Island, NY, USA Req #11764 Monday, March 4, 2024 Centers Plan for Healthy Living's goal is to...
  • 3/27/2024 12:00:00 AM

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Registered Nurse (Care Team Supervisor) - Bedford
  • AdvantageCare Physicians
  • Brooklyn, NY
  • Summary of Position •Provide professional nursing care to patients and proactively support efforts to ensure that standa...
  • 3/27/2024 12:00:00 AM

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Managed Care Coordinator
  • MJHS Health System
  • New York, NY
  • Req #: 1509 Job ID: 13084 Job Location(s): New York, NY Zip Code: 10040 Category: Office and Administrative Support Agen...
  • 3/26/2024 12:00:00 AM

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Manager-Care Coordination
  • St. Catherine of Siena
  • Rockville Centre, NY
  • Overview Manager, Care Coordination (RN), Rockville Centre, NY Explore a career with Mercy Hospital, a 375-bed not-for-p...
  • 3/26/2024 12:00:00 AM

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Care Coordinator, Care Management
  • Hackensack Meridian Health
  • Belmar, NJ
  • Description: Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients ...
  • 3/26/2024 12:00:00 AM

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Care Coordinator, Care Management
  • Hackensack Meridian Health
  • Spotswood, NJ
  • Description: Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients ...
  • 3/25/2024 12:00:00 AM

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Care Coordinator, Care Management
  • Hackensack Meridian Health
  • Neptune, NJ
  • Description: Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients ...
  • 3/25/2024 12:00:00 AM

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Care Coordinator, Care Management
  • Hackensack Meridian Health
  • Shrewsbury, NJ
  • Description: Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients ...
  • 3/25/2024 12:00:00 AM

Newark (/ˈnjuːərk/,[24] locally /njʊərk/)[25] is the most populous city in the U.S. state of New Jersey and the seat of Essex County.[26] As one of the nation's major air, shipping, and rail hubs, the city had a population of 285,154 in 2017, making it the nation's 70th-most populous municipality, after being ranked 63rd in the nation in 2000. Settled in 1666 by Puritans from New Haven Colony, Newark is one of the oldest cities in the United States. Its location at the mouth of the Passaic River (where it flows into Newark Bay) has made the city's waterfront an integral part of the Port of New...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$56,162 to $96,385
Newark, New Jersey area prices
were up 1.6% 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