Managed Care Coordinator jobs in Arizona

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
  • Phoenix, AZ 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.
  • 2 Months Ago

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Managed Care Contract Senior Biller
  • The CORE Institute
  • Phoenix, AZ FULL_TIME
  • Benefits: $22-25/hr Competitive Health & Welfare Benefits Monthly $43 stipend to use toward ancillary benefits HSA with qualifying HDHP plans with company match 401k plan after 6 months of service wit...
  • 1 Month Ago

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Continuing Care Coordinator - Main Campus
  • ALITA CARE
  • Wickenburg, AZ OTHER
  • Job Details Level: Entry Job Location: MBH The Meadows of Wickenburg - Wickenburg, AZ Position Type: Full Time Education Level: High School Diploma Salary Range: Undisclosed Job Shift: Day Job Categor...
  • 1 Month Ago

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Nurse Care Coordinator
  • Professional Health Care Network
  • Phoenix, AZ FULL_TIME
  • The Nurse Care Coordinator acts as a liaison in the coordination of resources and services to meet member’s needs, promotes teamwork to optimize efficient and cost-effective use of health care resourc...
  • 4 Days Ago

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Patient Care Coordinator
  • Weekend Dental Care
  • Tempe, AZ FULL_TIME
  • We are looking for an experienced dental front desk team member to provide excellent patient care/customer service , it includes phone answering scheduling, insurance verification, payment processing ...
  • 11 Days Ago

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Remote Bilingual Care Coordinator
  • Chronic Care Staffing
  • , AZ FULL_TIME
  • **Working Hours: 8:00am - 5:00pm PST** Job description Chronic Care Staffing is a nationwide provider of remote patient health services strictly following CMS service guidelines. We work with an array...
  • 11 Days Ago

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Case Manager (Care Coordinator)
  • Pacifica Hospital of the Valley
  • Los Angeles, CA
  • Job Description Job Description CARE COORDINTOR (CASE MANAGER) BEHAVIORAL HEALTH URGENT CARE CENTER (OUTPATIENT CLINIC) ...
  • 5/14/2024 12:00:00 AM

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Credentialing and Managed Care Coordinator
  • Texas Oncology
  • Richardson, TX
  • Overview: The US Oncology Network is looking for a Credentialing and Managed Care Coordinator to join our team at Texas ...
  • 5/14/2024 12:00:00 AM

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office manager/ care coordinator
  • 5 Stars Home Care LLC
  • Alexandria, VA
  • Job Description Job Description Job Summary: Duties: Responsible for all areas of Operations; human resources, intakes, ...
  • 5/13/2024 12:00:00 AM

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Managed Care Coordinator - Referrals
  • Beth Israel Lahey Health
  • Boston, MA
  • When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. Job Typ...
  • 5/11/2024 12:00:00 AM

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Managed Care Coordinator III
  • Metropolitan Jewish Health System
  • New York, NY
  • Overview: The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Med...
  • 5/11/2024 12:00:00 AM

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Department Manager, Care Coordination
  • Weeks Medical Center - CARE MANAGEMENT
  • Lancaster, NH
  • Position Details Employment Status: Full-Time Hours/Pay Period: 80 Is Remote: No Shift: Days Work Schedule: M - F Job Su...
  • 5/11/2024 12:00:00 AM

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Manager Care Coordination Social Work
  • CommonSpirit Health
  • Merced, CA
  • Overview: Mercy Medical Center a Dignity Health member has been building a rich history of care in our community for mor...
  • 5/11/2024 12:00:00 AM

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Case Manager (Care Coordinator)
  • Pacifica Hospital of the Valley
  • Los Angeles, CA
  • Job Description Job Description CARE COORDINTOR (CASE MANAGER) BEHAVIORAL HEALTH URGENT CARE CENTER (OUTPATIENT CLINIC) ...
  • 5/10/2024 12:00:00 AM

Arizona (/ˌærɪˈzoʊnə/ (listen); Navajo: Hoozdo Hahoodzo Navajo pronunciation: [xòːztò xɑ̀xòːtsò]; O'odham: Alĭ ṣonak Uto-Aztecan pronunciation: [ˡaɺi ˡʂonak]) is a state in the southwestern region of the United States. It is also part of the Western and the Mountain states. It is the sixth largest and the 14th most populous of the 50 states. Its capital and largest city is Phoenix. Arizona shares the Four Corners region with Utah, Colorado, and New Mexico; its other neighboring states are Nevada and California to the west and the Mexican states of Sonora and Baja California to the south and so...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$48,072 to $82,500

Managed Care Coordinator in New Orleans, LA
Health systems must meet the operational challenge of managing provider data for thousands of participating providers in their value-based care networks.
January 11, 2020
Managed Care Coordinator in Gainesville, FL
Many telehealth programs give patients easy access to any additional educational materials provided by their health plan or primary care provider.
December 23, 2019
Managed Care Coordinator in Houston, TX
Works with relevant parties to ensure deliverable from all parties are achieved in accordance with strategic timelines.Maintains CHSLI master list of service locations (facility, professional and continuing care)Assists in the resolution of referral, authorization and claims payment issuesSupports Directors in effort to educate and assist Hospital departments in meeting internal and MCO operational requirements.
December 27, 2019