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)
Responsibilities:
-Director, Managed Care
Position
The Claims Services department has an immediate opening for someone who can demonstrate the WCF values to join their team as a full-time Director, Managed Care. This posting is open to internal and external candidates and will work out of the Sandy, Utah headquarters.
Responsibilities
Qualifications
The most qualified applicants will have:
An internal candidate should have six months in their current position, acceptable job performance, and must notify their current supervisor that they've applied for the position.
INSURANCE DE&I MISSION
Promote and embrace a diverse, inclusive, equitable, and safe workplace.
INSURANCE IS AN EQUAL OPPORTUNITY EMPLOYER
Insurance provides equal employment opportunity to all qualified applicants and employees regardless of race, color, religion, sex, age, national origin, veteran status, disability that can be reasonably accommodated, or any other basis prohibited by federal, state, or local law.
Job Type: Full-time
Pay: $155,000.00 - $165,000.00 per year
Benefits:
Experience level:
Schedule:
Work Location: In person
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