Managed Care Coordinator jobs in Santa Rosa, 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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Care Coordinator
  • OLE Health
  • Saint Helena, CA FULL_TIME
  • POSITION TITLE: Care Coordinator

    DEPARTMENT: Care Coordination

    REPORTS TO: Care Coordination Manager

    SUPERVISION GIVEN: no

    LOCATION: St. Helena, CA

    HOURS: Mon to Fri, 40 hours a week

    PAY RANGE: $24.39 to $33.14


    About CommuniCare OLE

    Established in 2023, CommuniCare OLE is the result of a union of two health centers with a deep roots in their respective communities and reputations for providing high-quality primary care to all, regardless of insurance or ability to pay: OLE Health of Napa and Solano Counties and CommuniCare Health Centers of Yolo County. Building on a legacy established by both organizations in 1972, CommuniCare OLE is a network of federally-qualified health centers with 17 sites across Napa, Solano, and Yolo Counties. It offers comprehensive care, including medical, dental, behavioral health and substance use treatment, nutrition, optometry, pharmacy, care coordination, referrals, and enrollment assistance to more than 70,000 individuals, and no one is turned away due to lack of insurance, immigration status, or ability to pay. Many services are offered outside of its sites, including mobile health, home visiting, and community and school-based programs.


    JOB SUMMARY:
    The Care Coordinator is a member of the CommuniCare OLE clinical care team and works in continuous partnership with the patient, their family when appropriate, CommuniCare OLE care team, and relevant community partners to improve health outcomes and meet the patient’s desired health and wellness goals by:

    • Serving as the contact point, advocate, and informational resource for patients, family/caregiver(s), primary care team, payers, and community resources
    • Facilitating access to internal and external services
    • Identifying and addressing gaps in care
    • Increasing patient’s ability for self-management and shared decision-making


    KNOWLEDGE OF WORK

    Knowledge of Organizational Improvement Methods

    Knowledge care coordination best practices

    Knowledge of Federally Qualified Health Centers and the key health center principles and guidelines

    DUTIES AND RESPONSIBILITIES

    Evaluates social determinants of health, identifies barriers to care and addresses/resolves obstacles impeding progress

    Processes and closes the loop for community resource referrals

    Provides warm hand-offs for urgent and stat medical referrals and collaborates with referral coordinators to ensure medical referrals are processed

    Works with direct supervisor and QI department to ensure quality improvement initiatives are met

    Meets with each new patient and orients patient and family/caregiver(s) to CommuniCare OLE

    As a member of the care team, participates in huddles, team meetings, and case conferencing as needed

    Educates patient and family/caregiver(s) about relevant community resources

    Coordinates warm hand-offs for integrated care providers

    Provides support to primary care providers by completing forms and other tasks as needed

    Provides care management and creates care plans for patients on high-risk registry.

    Documents timely and efficiently in the EMR

    Attends appropriate training courses/webinars and meetings

    Gathers and reports data related to aspects of care coordination when needed

    Provides feedback for the improvement of Care Coordination processes

    Perform other duties as assigned


    EDUCATION, EXPERIENCE, TRAINING


    • High School Diploma or equivalent.
    • Experience working with diverse populations; displays respect and sensitivity to cultural diversity.
    • Experience working in community health setting.
    • Strong collaborative skills; ability to effectively and appropriately engage members of the care team, other clinic departments, leadership, and external community partners.
    • Exceptional communication skills; ability to effectively engage patients and assess needs and concerns to ensure that the patient is referred appropriately.
    • Excellent in-person and phone customer service skills; able to manage difficult and emotional patient situations and to respond promptly to patient needs.
    • Ability to adapt to change; approach challenges with an innovative and proactive attitude; and investigate resources.
    • Strong verbal and written communication skills required; Bilingual (English/Spanish) required.


    BENEFITS

    • Medical, Dental, Vision Coverage
      • Employer covers 90% of employee medical, dental and vision premium and 50% of dependent premium
    • 18 days of PTO (Vacation & Sick)
    • 10 Paid Holidays 1 Float Holiday
    • 4% Employer Match for 403(b) retirement plan
    • Tuition Reimbursement of up to $2,000 per Calendar Year for part-time and full-time employees (prorated per Full-Time Equivalent)
    • Life & Accidental Insurance Coverage
    • Employer contribution for Health Savings Account
    • Flexible Spending Account (FSA) and Limited FSA Options

  • 12 Days Ago

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Care Coordinator
  • OLE Health
  • Helena, CA FULL_TIME
  • POSITION TITLE: Care CoordinatorDEPARTMENT: Care CoordinationREPORTS TO: Care Coordination Manager SUPERVISION GIVEN: noLOCATION: St. Helena, CAHOURS: Mon to Fri, 40 hours a weekPAY RANGE: $24.39 to $...
  • 13 Days Ago

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Memory Care Program Coordinator
  • Brookdale Chanate
  • Santa Rosa, CA FULL_TIME
  • Overview Weekday Shifts Voted by Newsweek in 2024 as one of America's Greatest Workplaces for Diversity Early Access to Paycheck with Earned Wage Access is available for Hourly Associates (outside of ...
  • 18 Days Ago

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Care for Her Services Coordinator
  • MCHC Health Centers
  • Ukiah, CA FULL_TIME
  • DescriptionDescription: Mendocino Community Health Center (MCHC) is seeking a highly organized and detail-oriented individual to join our team as a Care for Her (CFH) Service Coordinator. The successf...
  • 19 Days Ago

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Patient Care Coordinator
  • Specialty1 Partners
  • Santa Rosa, CA FULL_TIME
  • Our office, Santa Rosa Endodontics, is seeking a Patient Care Coordinator to join our busy specialty practice. Our office is looking for a talented and pleasant patient care coordinator to take on all...
  • Just Posted

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Resident Care Coordinator
  • Orchard Park Senior Living
  • Clearlake, CA FULL_TIME
  • ```Duties```- Coordinate and oversee the care of residents in an assisted living or nursing home setting.- Assist with the development and implementation of care plans for each resident.- Monitor and ...
  • 9 Days Ago

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0 Managed Care Coordinator jobs found in Santa Rosa, CA area

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Remote Licensed Clinical Social Worker (LCSW)
  • Rula
  • Santa Rosa, CA
  • About Rula Rula is a comprehensive behavioral health solution that makes it easy for individuals, couples, and families ...
  • 4/24/2024 12:00:00 AM

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Occupational Therapist OT for Home Health
  • FeldCare Connects
  • Healdsburg, CA
  • FeldCare Connects, an app based referral network, is currently seeking a self-motivated Occupational Therapist to delive...
  • 4/24/2024 12:00:00 AM

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RN - MEDSURG 2 NEURO
  • Providence Health & Services
  • Santa Rosa, CA
  • RN - MEDSURG 2 NEURO Santa Rosa , California ReqID: 271732Job Category: Nursing-Patient FacingSchedule: Full timeShift: ...
  • 4/24/2024 12:00:00 AM

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Manager Rehabilitation Services - Home Health Care Services
  • Providence Health & Services
  • Santa Rosa, CA
  • DescriptionManager Rehabilitation- Home HealthSt. Joseph Home Care Network - Home Health Care Services- Sonoma, CASchedu...
  • 4/24/2024 12:00:00 AM

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Distribution Technician - Material Management
  • Providence Health & Services
  • Santa Rosa, CA
  • Job Description Supplies all departments with supplies and equipment needed to do their jobs and serve our patients. Cha...
  • 4/23/2024 12:00:00 AM

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Advanced Specialty Staff RN - Chemotherapy
  • Providence Health & Services
  • Santa Rosa, CA
  • Advanced Specialty Staff RN - Chemotherapy Santa Rosa , California ReqID: 274138Job Category: Nursing-Patient FacingSche...
  • 4/23/2024 12:00:00 AM

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Cook
  • The Vineyard at Fountaingrove
  • Santa Rosa, CA
  • The Vineyard at Fountaingrove - Are you looking for a new best friend, card-game companion, or gardening guru? Then cons...
  • 4/22/2024 12:00:00 AM

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Pharmacy Analyst-340B
  • Providence Health & Services
  • Santa Rosa, CA
  • Job Description Leads the implementation, maintenance and compliance monitoring of the 340B drug purchasing program. Res...
  • 4/21/2024 12:00:00 AM

According to the United States Census Bureau, the city has a total area of 41.50 sq mi (107.5 km2), of which 41.29 sq mi (106.9 km2) is land and 0.205 sq mi (0.5 km2) (0.49%) is water. The city is part of the North Bay region, which includes such cities as Petaluma, Rohnert Park, Windsor, and smaller cities as Sonoma, Healdsburg, Sebastopol. It lies along the US Route 101 corridor, approximately 55 miles (89 km) north of San Francisco, via the Golden Gate Bridge. Santa Rosa lies on the Santa Rosa Plain. The city's eastern extremities stretch into the Valley of the Moon, and the Sonoma Creek wa...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$54,433 to $93,415
Santa Rosa, California area prices
were up 2.5% from a year ago

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