Managed Care Coordinator jobs in Toledo, OH

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
  • Toledo, OH 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.
  • 8 Days Ago

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Care Coordinator
  • Ohioans Home Healthcare & Hospice
  • Perrysburg, OH FULL_TIME
  • Location: Perrysburg, OH You make patient care your top priority. As a Care Coordinator at Ohioans Home Healthcare, your highly organized nature and detail-oriented approach are key assets in coordina...
  • 21 Days Ago

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Care Coordinator
  • Unison Health
  • Toledo, OH FULL_TIME
  • Come work your passion with us! Unison Health is hiring experienced individuals to train as full-time Care Coordinators to work with children/youth with behavioral or developmental disability health c...
  • 3 Days Ago

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IT Technician
  • Velocity A Managed Services Company
  • Holland, OH FULL_TIME
  • Velocity is seeking to hire a Repair Technician. The Repair Technician analyzes, troubleshoots, and repairs dye sublimation printers and related equipment; as well as documents all activities performe...
  • 19 Days Ago

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Service Desk Support Analyst Toledo/Maumee
  • Frontline Managed Services
  • Maumee, OH FULL_TIME
  • DescriptionElevate your IT journey with Frontline Managed Services! We're on the lookout for Help Desk team players who are not just tech-savvy but hungry for knowledge and ready to make an impact. Jo...
  • 23 Days Ago

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Product Integration Technician
  • Velocity A Managed Services Company
  • Holland, OH FULL_TIME
  • General Summary: The Product Integration Technician position at Velocity works out of our world-class Enterprise Solutions Repair and Logistics Facility. This position configures, processes, and packa...
  • 2 Days Ago

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0 Managed Care Coordinator jobs found in Toledo, OH area

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Pediatric Behavioral Health Care Manager
  • University of Toledo Physicians
  • Toledo, OH
  • Job Description Job Description University of Toledo Physicians' mission is to improve the human condition through excel...
  • 3/28/2024 12:00:00 AM

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Nurse Practitioner - Advanced Practice Provider
  • Oak Street Health Inc.
  • Toledo, OH
  • Title: Nurse Practitioner - Advanced Practice Provider Schedule: Full-Time, Monday through Friday, 8:00 AM - 5:00 PM Loc...
  • 3/28/2024 12:00:00 AM

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ICU RN-Full Time Day Shift
  • Bon Secours Mercy Health
  • Perrysburg, OH
  • At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectivenes...
  • 3/28/2024 12:00:00 AM

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ICU RN-Weekend Only Incentive Program-Part Time
  • Bon Secours Mercy Health
  • Perrysburg, OH
  • At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectivenes...
  • 3/28/2024 12:00:00 AM

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Nurse Practitioner or Physician Assistant - $10k Sign on bonus (61121)
  • Curana Health
  • Toledo, OH
  • Curana Health is a provider-led, primary and post acute organization focused on senior living communities and senior liv...
  • 3/27/2024 12:00:00 AM

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RN / Registered Nurse - Home Care - Part Time - Days
  • ProMedica
  • Sylvania, OH
  • **Job Details** **RN / Registered Nurse - Home Care - Part Time - Days - (53902)** This details all the information abou...
  • 3/25/2024 12:00:00 AM

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Wound Care Coordinator
  • Encompass Health
  • Toledo, OH
  • The Wound Care Coordinator directs, organizes, and develops all wound care services in accordance with applicable federa...
  • 3/24/2024 12:00:00 AM

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Unit Care Coordinator (Registered Nurse/RN)
  • Rivergate Terrace
  • Riverview, MI
  • Live the Mission Position Summary The RN Unit Care Coordinator is responsible for supervising, implementing, coordinatin...
  • 3/24/2024 12:00:00 AM

Toledo (/təˈliːdoʊ/) is a city in and the county seat of Lucas County, Ohio, United States. Toledo is in northwest Ohio, at the western end of Lake Erie bordering the state of Michigan. The city was founded in 1833 on the west bank of the Maumee River, and originally incorporated as part of Monroe County, Michigan Territory. It was re-founded in 1837, after conclusion of the Toledo War, when it was incorporated in Ohio. After the 1845 completion of the Miami and Erie Canal, Toledo grew quickly; it also benefited from its position on the railway line between New York City and Chicago. The first...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$47,941 to $82,276
Toledo, Ohio area prices
were up 1.3% 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