Managed Care Coordinator jobs in Salt Lake City, UT

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 of Managed care/ insurance or healthcare
  • Top Tier Consulting LLC
  • Sandy, UT FULL_TIME
  • Responsibilities:
    -Director, Managed Care

    • Sandy, UT, United States
    • Full Time
    • 10 paid holidays, 6% 401 k match, PTO, tuition reimbursement, and more

    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

    • Oversee the overall performance and outcomes of the managed care departments including Utilization Review, Medical Case Management, Vocational Rehabilitation, and Bill Review.
    • Collaborate with internal stakeholders, such as claims management, underwriting, legal, and finance, to ensure effective coordination of managed care initiatives.
    • Build and maintain relationships with external partners, including medical providers, pharmacy benefit managers, and other vendors.
    • Develop and implement strategic initiatives to enhance our managed care programs, ensuring alignment with organizational goals and objectives.
    • Leverage data analytics and industry best practices to optimize patient outcomes, reduce costs, and streamline processes.
    • Collaborate with internal stakeholders, such as claims management, underwriting, legal, and finance, to ensure effective coordination of managed care initiatives.
    • Build and maintain relationships with external partners, including medical providers, pharmacy benefit managers, and other vendors.
    • Ensure compliance with all relevant state and federal regulations governing managed care programs, staying up to date on industry changes and implementing necessary adjustments to maintain compliance.
    • Develop and track key performance indicators (KPIs) to evaluate the success of managed care programs.
    • Provide regular reports and analysis to claims management, highlighting program performance, outcomes, and opportunities for improvement

    Qualifications

    The most qualified applicants will have:

    • At least 6-8 years of experience in managed care, healthcare administration, or a similar role within the insurance industry.
    • Strong knowledge of workers' compensation regulations, managed care principles, and medical treatment guidelines.
    • Familiarity with utilization review processes, case management principles, and pharmacy benefit management is highly desirable.
    • Proven experience in managing and leading cross-functional teams and departments.
    • Excellent communication and interpersonal skills, with the ability to build and maintain relationships with internal and external stakeholders.
    • Strong analytical and problem-solving abilities, with proficiency in data analysis and reporting.
    • Demonstrated ability to drive process improvements and implement innovative solutions.
    • Bachelor's degree in healthcare administration, business administration, or a related field. Master's degree preferred.

    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:

    • 401(k)
    • Dental insurance
    • Health insurance
    • Life insurance
    • Paid time off
    • Vision insurance

    Experience level:

    • 6 years
    • 7 years
    • 8 years

    Schedule:

    • Monday to Friday

    Work Location: In person

  • 4 Days Ago

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Care Coordinator
  • Creekside Senior Living
  • Bountiful, UT FULL_TIME
  • Care Coordinator - Large Senior Living CommunityWe are seeking an outstanding Care Coordinator to join our team at a large senior living community in Bountiful. Come join a team of dedicated, smart, a...
  • 8 Days Ago

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Airport Rental Car Cleaner ($15.00 per hour • Daily Pay Access)
  • Managed Labor Solutions
  • Salt Lake, UT FULL_TIME
  • Do you enjoy late model cars, have a good attention to detail, and need a flexible schedule plus access to daily pay? Managed Labor Solutions (MLS), a leading nationwide rental car outsourcing company...
  • 22 Days Ago

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Limpiador de Coches de Alquiler ($15.00 por hora)
  • Managed Labor Solutions
  • Salt Lake, UT FULL_TIME
  • Te gustan los coches de ultimo modelo y tienes buena atencion a los detalles? Managed Labor Solutions (MLS), una empresa de subcontratacion de vehiculos de alquiler a nivel nacional, esta contratando ...
  • 10 Days Ago

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Volunteer coordinator
  • Canyon Home Care & Hospice
  • Tooele, UT VOLUNTEER
  • Description JOB DESCRIPTION The Volunteer Specialist is directly responsible to the Volunteer Coordinator for patient / family needs and services. The Volunteer Specialist is responsible for coordinat...
  • 1 Day Ago

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Insurance Coordinator
  • Fresenius Medical Care
  • West Valley, UT FULL_TIME
  • PURPOSE AND SCOPE: Explores, recommends, and coordinates the insurance and potential financial assistance options available to kidney dialysis patients in a specified geographic area, while maximizing...
  • 4 Days Ago

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0 Managed Care Coordinator jobs found in Salt Lake City, UT area

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LICENSED CLINICIAL SOCIAL WORKER - PRN
  • BrightSpring Health Services
  • Salt Lake City, UT
  • Our Company Rehab Without Walls Neuro Rehabilitation Overview ELEVATE YOUR CAREER & MAKE AN IMPACT WITH HOME AND COMMUNI...
  • 3/29/2024 12:00:00 AM

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MedTech
  • Escalante at Coventry
  • Salt Lake City, UT
  • Escalante at Coventry - Medication Technician: Frontier Management is seeking an outstanding Medication Technician for E...
  • 3/28/2024 12:00:00 AM

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Telephonic Complex Nurse Case Manager
  • AmTrust Financial Services, Inc.
  • Salt Lake City, UT
  • Overview AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Complex Care Case Man...
  • 3/28/2024 12:00:00 AM

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Nurse Practitioners and Physician Assistants
  • DispatchHealth
  • Salt Lake City, UT
  • How You'll Make an Impact We are hiring Nurse Practitioners and Physician Assistants with acute care experience in ER, U...
  • 3/28/2024 12:00:00 AM

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PHARMACIST
  • BrightSpring Health Services
  • Salt Lake City, UT
  • Our Company PharMerica Overview Our Pharmacy group focuses on providing exceptional customer service and meeting the pha...
  • 3/28/2024 12:00:00 AM

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Behavioral Health Therapist - Substance Use Disorders
  • Sacred Circle
  • Salt Lake City, UT
  • Job Description Job Description As an entity of the Confederated Tribes of the Goshute Reservation, we, at Sacred Circle...
  • 3/27/2024 12:00:00 AM

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Residential Supervisor Adolescent Behavioral Health
  • Newport Healthcare
  • Oakley, UT
  • About Us: Newport Healthcare is a nationwide behavioral healthcare organization dedicated to transforming young lives th...
  • 3/27/2024 12:00:00 AM

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Residential Supervisor Adolescent Behavioral Health Evening/Overnight
  • Newport Healthcare
  • Oakley, UT
  • About Us: Newport Healthcare is a nationwide behavioral healthcare organization dedicated to transforming young lives th...
  • 3/25/2024 12:00:00 AM

Salt Lake City has an area of 110.4 square miles (286 km2) and an average elevation of 4,327 feet (1,319 m) above sea level. The lowest point within the boundaries of the city is 4,210 feet (1,280 m) near the Jordan River and the Great Salt Lake, and the highest is Grandview Peak, at 9,410 feet (2,868 m). The city is in the northeast corner of the Salt Lake Valley surrounded by the Great Salt Lake to the northwest, the steep Wasatch Range to the east, and Oquirrh Mountains to the west. Its encircling mountains contain several narrow canyons, including City Creek, Emigration, Millcreek, and Par...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$47,594 to $81,681
Salt Lake City, Utah area prices
were up 2.3% 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