Managed Care Coordinator jobs in Waukegan, IL
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)
Recently Added Managed Care Coordinator jobs
RN Care Manager
- Managed Health Services Wisconsin
-
Racine, WI
FULL_TIME
-
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
* We are currently offering a $5,000 sign-on bonus for this position *
** This hybrid remote role requires less than 50% travel in Milwaukee / Appleton area and candidates will have the flexibility to work remotely from their home the remaining time **
Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.
• Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
• Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes
• Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
• Provide patient and provider education
• Facilitate member access to community based services
• Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan
• Actively participate in integrated team care management rounds
• Identify related risk management quality concerns and report these scenarios to the appropriate resources.
• Case load will reflect heavier weighting of complex cases than Care Manager I, commensurate with experience
• Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
• Direct care to participating network providers
• Perform duties independently, demonstrating advanced understanding of complex care management principles.
• Participate in case management committees and work on special projects related to case management as needed
Education/Experience: Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred. 2 years of clinical nursing experience in a clinical, acute care, or community setting and 1 years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs.Licenses/Certifications: Current state’s RN license and a valid driver's license
Pay Range: $66,100.00 - $118,900.00 per year
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
About the Company:
Managed Health Services Wisconsin
- 1 Month Ago
Care Manager II (RN) - Now Hiring
- Managed Health Services WI
-
Kansasville, WI
FULL_TIME
- You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offeri...
- 7 Days Ago
Home Care Service Coordinator
- Bickford Home Care
-
Crystal, IL
FULL_TIME
- Bickford Home Care is seeking compassionate, attentive, and trustworthy employees. Please join our mission in providing extraordinary in-home care to seniors. We want our caregivers to know that they ...
- Just Posted
Care coordinator
- Catholic Charities of the Archdiocese of Chicago
-
Round Lake, IL
FULL_TIME
- Job Description Essential Functions of the position are detailed below, and include any physical requirements below that. 1. Works independently and consistently exercises discretion and sound judgmen...
- 7 Days Ago
Resident Service Coordinator
- Champion Care
-
Kenosha, WI
FULL_TIME
- Become a part of Waters Edege's Family and make a difference in our Residents' lives! Waters Edge Health and Rehab is hiring for a customer service driven Resident Service Coordinator to join our team...
- 7 Days Ago
MDS Coordinator
- Elevate Care Waukegan
-
Waukegan, IL
FULL_TIME
- Elevate Care is seeking a MDS Coordinator. This is a vital role in a facility with a positive community reputation, a history of successful outcomes, and an experienced cohesive team. At Elevate Care,...
- 24 Days Ago
Filters
- Current Active Filter
- Waukegan, IL
Clear All
- Filter Jobs By posted time
- Within 1 Day
- Within 2-7
- Within 1 Month
- Within 3 Months
0 Managed Care Coordinator jobs found in Waukegan, IL area
Addiction Counselor-LI (Remote Opportunity)Telehealth Behavioral Health
- NYC Health + Hospitals
-
Chicago, IL
- 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
Director of Care Coordination
- The Exeter Group
-
Chicago, IL
- Job Description Job Description The Director of Care Coordination is accountable for the leadership and oversight of Car...
- 4/22/2024 12:00:00 AM
Medicaid Care Coordinator
- Managed Care Staffers
-
Chicago, IL
- Job Description Job Description Temp-to-hire Medicaid Care Coordinator, Chicago, IL Our client, an ACO, located on the n...
- 4/22/2024 12:00:00 AM
Health Care Coordinator
- Ada S. Mckinley Community Services Inc.
-
Chicago, IL
- Annual Salary: $46,190.00 Employment Status: Full-Time Location: McCrone Industries Company Description: The mission of ...
- 4/22/2024 12:00:00 AM
Resident Care Coordinator and Scheduler
- Frontier Management
-
Lake Zurich, IL
- Frontier Senior Living is seeking an outstanding Resident Care Coordinator to join The Auberge at Lake Zurich community ...
- 4/22/2024 12:00:00 AM
Care Coordinator (IL Medicaid) - Central IL
- Humana
-
Chicago, IL
- Become a part of our caring community and help us put health firstHumana Gold Plus Integrated is seeking Care Coordinato...
- 4/22/2024 12:00:00 AM
Care Coordinator
- Haymarket Center
-
Chicago, IL
- Job Description Job Description WORK DESCRIPTION: Working closely with the medical providers and care coordination team,...
- 4/20/2024 12:00:00 AM
Addiction Counselor-LI (Remote Opportunity)Telehealth Behavioral Health
- Nyc Health + Hospitals
-
Chicago, IL
- About NYC Health + Hospitals: Lincoln Medical and Mental Health Center is one of New York Citys premier acute care hospi...
- 4/20/2024 12:00:00 AM
About Waukegan, Illinois
Waukegan /wɔːˈkiːɡən/ is the largest city in and the county seat of Lake County, Illinois, United States, a part of the Chicago metropolitan area. The city is located 35 miles north of the Loop and 10 miles south of the Wisconsin state border, approximately halfway between Chicago and Milwaukee. As of the 2013 United States Census estimate, the city has a population of 88,826, which makes it the ninth most populous city in Illinois. Waukegan is a predominately working-class community with a size-able middle-class population.
Waukegan is located at 42°22′13″N 87°52′16″W / 42.37028°N 87.87111...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$48,916 to $83,946
Waukegan, Illinois area prices
were up 1.8% from a year ago
were up 1.8% from a year ago
What does a Managed Care Coordinator do?
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