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)
Salary Range: $21.22 - $23.90 Hourly
*
Summary:*
Under the direct supervision of the Director of Managed Care Services, the Managed Care Enrollment Coordinator is responsible for coordinating and implementing member’s enrollment into Managed Care Health Plans and selection of Primary Care Physician, transfers of plans and providers, eligibility verification, information and education for patients. Prepares monthly reports, detailing enrollment for the current month and performs plan relations and other duties as assigned.
DUTIES AND RESPONSIBILITIES:
*
REQUIREMENTS:*
Job Type: Full-time
Pay: $16.94 - $22.92 per hour
Clear All
0 Managed Care Coordinator jobs found in Pasadena, CA area