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)
If you want to work for a growing system of community health centers which is committed to providing quality care or patients of all ages and to the growth, education, and development of its staff, then TCC Family Health has a great employment opportunity for you.
The Care Coordinator is responsible for providing patients with appropriate referrals to internal/external resources and agencies, coordinate specialty care for clinic patients, schedule appointments for clinic patients with a provider of a physician, serve as a liaison between the Provider, Registered Nurse (RN), Licensed Vocational Nurse (LVN), and Care Team Supervisor to ensure patients receive appropriate care. Must interact in a positive manner with staff, patients, families, and members of the community.
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SPECIFIC JOB COMPETENCIES: (Referrals)
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Work Environment
The noise level of the work environment is usually moderate. Workspace is in an indoor office setting, shared workspace, air-conditioned in the summer and central heat during the winter. Occasionally required to be outdoors for travel, and can be exposed to variable weather conditions.
GENEROUS COMPANY BENEFITS:
TCC Family Health was founded in 1939 by a group of physicians and community leaders who recognized the importance of access to healthcare for all children, particularly those who are from low-income families and who are at risk for health problems. Since then, TCC has grown from offering weekly well-child care to daily, full-service health care with primary care services for children, adolescents, and adults. TCC is known as a unique leader in the greater Long Beach community, addressing disparities in health by providing quality care for the under-served of all ages, offering them a true “medical home”.
Job Type: Full-time
Pay: $21.44 - $25.00 per hour
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Work Location: In person
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