Managed Care Coordinator jobs in San Antonio, TX

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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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • San Antonio, TX FULL_TIME
  • We are currently seeking a skilled and motivated Pharmacist with expertise in Pharmacy Benefit Management (PBM) and Managed Care. In this pivotal role, you will be responsible for overseeing medication utilization, formulary management, and ensuring cost-effective pharmacy services. The ideal candidate will bring a deep understanding of managed care principles, a proactive approach to problem-solving, and a commitment to optimizing pharmacy outcomes within a managed care environment.

    Preferred Qualifications:
    PharmD degree from an accredited pharmacy program
    Previous experience in Pharmacy Benefit Management (PBM) or Managed Care
    Knowledge of formulary development and management
    State pharmacy license in good standing
    Strong analytical and data interpretation skills
    Excellent communication and negotiation abilities
    Familiarity with healthcare regulations and compliance standards
    Collaboration experience with healthcare providers, payers, and pharmaceutical manufacturers
    Proficiency in utilizing pharmacy management software and tools
    Active participation in relevant professional organizations
    Dedication to staying informed about industry trends and innovations

    Responsibilities:
    Collaborate with healthcare stakeholders to implement and optimize pharmacy benefit programs
    Conduct formulary reviews and assessments to ensure cost-effective and evidence-based medication choices
    Monitor and analyze pharmacy utilization trends, identifying opportunities for cost savings and improved patient outcomes
    Provide expertise in drug utilization management and prior authorization processes
    Stay informed about industry regulations, guidelines, and emerging trends in managed care pharmacy
    If you are a passionate and experienced pharmacist with a background in PBM or Managed Care, we invite you to join our dynamic team dedicated to advancing healthcare through innovative and cost-effective pharmacy solutions. Apply now to contribute to the future of managed care pharmacy.
  • 1 Month Ago

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Managed Vision Care - Billing Operations Supv, Billing Operations
  • VisionWorks
  • San Antonio, TX FULL_TIME
  • Summary: The Billing Operations Supervisor is responsible for leading, guiding and training all assigned Billing Operations Team Lead and Associates along with overseeing the day to day activities of ...
  • 1 Month Ago

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Care Coordinator
  • The Medical Team, Inc
  • San Antonio, TX FULL_TIME
  • SUMMARY: A Care Coordinator is responsible for staffing Personal Care Attendants (PCA). The Care Coordinator will serve as a liaison between PCA’s and Supervisors to confirm assignments. Duties and Re...
  • 1 Month Ago

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Care Coordinator
  • HILL COUNTRY M H D D CENTERS
  • Boerne, TX OTHER
  • Job Details Level: Experienced Job Location: Kendall County MH Center - Boerne, TX Education Level: 4 Year Degree Salary Range: Undisclosed Who we are and what you'll do:At Hill Country Mental Health ...
  • 25 Days Ago

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Care Coordinator
  • Hill Country M H D D Centers
  • Boerne, TX FULL_TIME
  • At Hill Country Mental Health and Developmental Disabilities Center our vision is to empower people, foster hope, support choice, and celebrate success. **HILL COUNTRY MHDD CENTERS IS OFFERING A $2,00...
  • 30 Days Ago

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Care coordinator
  • Hill Country Community Mental Health and Developmental Disabilities Centers
  • Boerne, TX FULL_TIME
  • At Hill Country Mental Health and Developmental Disabilities Center our vision is to empower people, foster hope, support choice, and celebrate success. HILL COUNTRY MHDD CENTERS IS OFFERING A $2,000 ...
  • 1 Month Ago

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0 Managed Care Coordinator jobs found in San Antonio, TX area

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Care Coordinator (Tier 2)
  • MRI
  • San Antonio, TX
  • Job Description Job Description ** Remote (Needs To Live Near San Antonio, TX) ** ** 3+ Month Long Contract (Opportunity...
  • 4/25/2024 12:00:00 AM

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Addiction Counselor-LI (Remote Opportunity)Telehealth Behavioral Health
  • Nyc Health + Hospitals
  • San Antonio, TX
  • About NYC Health + Hospitals: Lincoln Medical and Mental Health Center is one of New York Citys premier acute care hospi...
  • 4/25/2024 12:00:00 AM

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Wound Care Coordinator, RN
  • Kindred
  • San Antonio, TX
  • The Wound Care Coordinator manages the facility wound care program including standards of care and practice related to w...
  • 4/24/2024 12:00:00 AM

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Addiction Counselor-LI (Remote Opportunity)Telehealth Behavioral Health
  • NYC Health + Hospitals
  • San Antonio, TX
  • About NYC Health + Hospitals: Lincoln Medical and Mental Health Center is one of New York City’s premier acute care hosp...
  • 4/24/2024 12:00:00 AM

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Patient Care Coordinator
  • Rose International
  • San Antonio, TX
  • Date Posted: 04/04/2024 Hiring Organization: Rose International Position Number: 461687 Job Title: Patient Care Coordina...
  • 4/23/2024 12:00:00 AM

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Licensed Vocational Nurse -Care Coordination
  • Methodist Healthcare Ministries
  • San Antonio, TX
  • Essential Duties: * Works with Care Coordination RN to promote and reinforce patient centered medical home concepts with...
  • 4/23/2024 12:00:00 AM

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Patient Care Coordinator
  • University Health System
  • San Antonio, TX
  • Full Time 4502 Medical Dr. Management Day Shift POSITION SUMMARY/RESPONSIBILITIES Perform expert leadership skills in ma...
  • 4/22/2024 12:00:00 AM

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Wound Care Coordinator, RN
  • Kindred
  • San Antonio, TX
  • The Wound Care Coordinator manages the facility wound care program including standards of care and practice related to w...
  • 4/22/2024 12:00:00 AM

San Antonio (/ˌsæn ænˈtoʊnioʊ/; from Spanish, "Saint Anthony"), officially the City of San Antonio, is the seventh-most populous city in the United States, and the second-most populous city in both Texas and the Southern United States, with more than 1.5 million residents. Founded as a Spanish mission and colonial outpost in 1718, the city became the first chartered civil settlement in present-day Texas in 1731. The area was still part of the Spanish Empire, and later of the Mexican Republic. Today it is the state's oldest municipality. The city's deep history is contrasted with its rapid rec...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$46,600 to $79,973
San Antonio, Texas area prices
were up 1.2% 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