Managed Care Coordinator jobs in Roseville, CA

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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Director, Managed Care
  • Adventist Health
  • Roseville, CA FULL_TIME
  • Adventist Health is ranked #10 in Becker's list of the largest nonprofit hospital systems in the U.S. We are the largest company headquartered and sixth largest employer in Roseville, California. Our corporate headquarters have been located at a desirable location on Douglas Boulevard since 1984. To accommodate our growing services, we are creating a new campus that will not only bring our workforce of nearly 900 people together in one location, but also facilitate a deeper connection with our Roseville neighbors and community.

    Job Summary:

    Assumes responsibility for hospital managed care contracting, payer in-servicing, contract implementation and contract reporting at designated hospitals. Works in association with the hospital chief financial officer (CFO) on contract matters. Serves as liaison with hospital affiliated independent practice associations (IPAs) and medical groups. Supervises and directs the activities of various levels of assigned personnel using both professional and supervisory discretion and independent judgment.

    Job Requirements:

    Education and Work Experience:

    • Bachelor’s Degree or equivalent combination of education/related experience: Required
    • Master's Degree: Preferred
    • Seven years' technical experience: Preferred
    • Five years' leadership experience: Preferred

    Essential Functions:

    • Maintains responsibility for payer contracts with Adventist Health Physician Network, rural health clinics and other Adventist Health affiliated physician organizations. Manages, directs, and leads the departmental staff to ensure maximum productivity and efficiency. Exercises independent judgment in recruiting, training, coaching, supervising and responsibly directing assigned staff. Directs, organizes, and plans the operation of assigned department at the center and market level.
    • Responsible for payer contracts for home health services and coordinating contracting activities with managed care and/or physician organizations. Coordinates care, services, and programming across departments and services.
    • Ensures compliance with local, state, and federal regulations.
    • Plans/monitors/maintains, FTE, capital, and operational budgets. Reviews department systems, concerns, budgets, and goals with physicians, including cost reduction and revenue enhancement.
    • Performs other job-related duties as assigned.

    Organizational Requirements:

    Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.

  • 11 Days Ago

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MANAGED CARE SOCIAL WORKER
  • River City Medical Group
  • Sacramento, CA FULL_TIME
  • Job Summary:Under the direction of the VicePresident Program Development/Community Relations provide direct counseling to members about availability of entitlement and social service programs. Identif...
  • 2 Months Ago

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Assistant Director of Managed Care - Hybrid Sacramento CA
  • California Primary Care Association
  • Sacramento, CA FULL_TIME
  • Association’s Mission: California Primary Care Association's mission is to lead and position community clinics, health centers, and networks through advocacy, education, and services as key players in...
  • 10 Days Ago

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Clinical Practice Manager, Managed Care Kaiser - Wrap
  • Stanford Sierra Youth & Families
  • Sacramento, CA FULL_TIME
  • *$3,000 Hiring Bonus * QUALIFICATIONS Education & Experience Master's Degree in a related field LCSW/ASW, LMFT/AMFT required, current registration with Board of Behavioral Sciences Minimum 2 years’ ex...
  • Just Posted

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Mobile Diesel Technician - Advanced
  • Managed Mobile
  • Sacramento, CA FULL_TIME
  • Managed Mobile is looking for an advanced level Journeyman Technician with a wide breadth of experience who can diagnose and repair medium/heavy duty trucks. The selected candidate will work independe...
  • 23 Days Ago

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Apprentice Diesel Technician
  • Managed Mobile
  • Sacramento, CA FULL_TIME
  • Managed Mobile, Inc. is the market leader for commercial fleet maintenance in California and Nevada. We have an excellent entry level opportunity for new Technicians looking for a career pathway to be...
  • 23 Days Ago

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0 Managed Care Coordinator jobs found in Roseville, CA area

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Patient Care Coordinator- part time
  • Joint Ventures LLC
  • Sacramento, CA
  • Job Type Part-time Description Patient Care Coordinator (Wellness Coordinator) About The Joint Chiropractic: The Joint i...
  • 5/9/2024 12:00:00 AM

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Memory Care Resident Care Coordinator for Assisted Living Community
  • Fair Oaks Estates
  • Carmichael, CA
  • Job Description Job Description We are seeking a Memory Care Resident Care Coordinator to become a part of our team! The...
  • 5/9/2024 12:00:00 AM

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Care Coordinator Behavioral Health
  • Newport Healthcare
  • Shingle Springs, CA
  • About Us: Newport Healthcare is a nationwide behavioral healthcare organization dedicated to transforming young lives th...
  • 5/8/2024 12:00:00 AM

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Medical Director, Operations
  • Blue Shield of California
  • El Dorado Hills, CA
  • Your Role The Medical Director, Commercial is a key member of the Medical Management and Operations staff within Health ...
  • 5/8/2024 12:00:00 AM

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Receptionist/Patient Care Coordinator
  • Capital Village Dental
  • Sacramento, CA
  • Job Description Job Description We are a fast-paced, modern, contemporary dental practice in the Greater Rancho Cordova ...
  • 5/6/2024 12:00:00 AM

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Receptionist/Patient Care Coordinator
  • Capital Village Dental
  • Rancho Cordova, CA
  • Job Description Job Description We are a fast-paced, modern, contemporary dental practice in the Greater Rancho Cordova ...
  • 5/6/2024 12:00:00 AM

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CUSTOMER CARE COORDINATOR
  • River City Staffing Group
  • Folsom, CA
  • Customer Service professional needed in the Rancho Cordova area for a large non-profit organization. This is a great opp...
  • 5/5/2024 12:00:00 AM

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Care Coordinator
  • RIVER OAK CENTER FOR CHILDREN INC
  • Elk Grove, CA
  • Job Details Level Experienced Job Location Elk Grove - Elk Grove, CA Position Type Full Time Education Level Graduate De...
  • 5/5/2024 12:00:00 AM

Roseville (formerly, Roseville Junction, Junction, and Grider's) is the largest city in Placer County, California, United States, in the Sacramento metropolitan area. As of 2016, the US Census Bureau estimated the city's population to be 132,683. Interstate 80 runs through Roseville and State Route 65 runs through part of the northern edge of the city. According to the Roseville Civic Center, the city has a total area of 42.26 square miles (109.5 km2), of which, 42.24 square miles (109.4 km2) of it is land and 0.002 square miles (0.0052 km2) of it (0.00%) is water. Several streams flow through...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$53,205 to $91,309
Roseville, California area prices
were up 2.5% 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