Managed Care Coordinator jobs in Delaware

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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Managed Care Coordinator
  • Modern Maturity Center Inc
  • Dover, DE FULL_TIME
  •  

    Managed Care Coordinator (MCO) – FT

    Monday – Friday 8:00 am to 4:30 pm

    (Healthcare benefits package including paid vacation and sick time)

      

    SUMMARY  

    Organizes and enters data into computer to develop reports for Managed Care billing, tracks, records, and prepares data of delivered meals from all sites, coordinates paperwork among MANNA staff.

     

    ESSENTIAL DUTIES AND RESPONSIBILITIES

    • Maintains confidentiality of all personal / health related information observed
    • Receives authorizations and organizes, coordinates, keeps records of, and disseminates information to appropriate sources regarding service dates and terminations
    • Reviews authorizations for completeness and accuracy. Follows up as needed to obtain missing information.
    • Liaison with Case Managers and clients on this program. Answer questions, concerns, complaints. Refers issues to appropriate staff for resolution.
    • Prepares and sorts source documents, identifies, and interprets data to be entered
    • Enters alphabetic, numeric, or symbolic data from source documents into computer following format displayed on screen, and enters necessary codes
    • Makes necessary corrections to information entered
    • Compiles, sorts, and verifies accuracy of data to be entered
    • Keeps record of work completed
    • Files or routes source documents after entry
    • Responds to inquiries regarding entered data
    • Other duties maybe assigned\

    COMPETENCY

    • Maintains confidentiality
    • Collects and researches data
    • Contributes to building a positive team spirit
    • Presents numerical data effectively
    • Able to read and interpret written information
    • Shows respect and sensitivity for cultural differences
    • Upholds organizational values
    • Completes administrative tasks correctly and on time
    • Is consistently at work and on time
    • Treats others with respect and consideration regardless of their status or position
    • Demonstrates accuracy and thoroughness
    • Completes work in timely manner
    • Observes safety and security procedures                                     

    EDUCATION/EXPERIENCE

    • Must have high school diploma or general education degree (GED)
    • Degree in human services, business, or related field preferred, or combination of experience and degree.

    COMPUTER SKILLS 

    • Must have knowledge of Microsoft Word and Excel software 

    WORK ENVIRONMENT

    The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.  The noise level in the work environment is usually quiet and low key.

     

     

    Because of the high volume of applications, we receive, we are not able to give status updates, but if you are invited for an interview, you will be contacted directly by the Human Resources Department for this position.

     

    We provide equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, genetics or any other protected class or characteristic. 

     

     

     

     

  • 2 Months Ago

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Registered Nurse, Home Health Per-Diem Summer Seasonal
  • Cape Regional Home Health Care Managed by BAYADA
  • Lewes, DE PER_DIEM
  • Summer is right around the corner; would you like to spend more time by the shore this summer? Cape Regional Home Health Care Managed by BAYADA is looking for compassionate and dedicated Per Diem Summ...
  • 7 Days Ago

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Care Coordinator
  • HomeWell Care Services of Delaware
  • Smyrna, DE PART_TIME
  • SUMMARY: Under the direction of the Chief Operations Officer and Agency Director, the Care Coordinator is responsible for organizing and coordinating, implementing, and supervising the delivery of ser...
  • 1 Month Ago

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RN Care Coordinator
  • Christiana Care Health System
  • Wilmington, DE FULL_TIME
  • Job DetailsRN Care Coordinator (Longitudinal)Day Shift (Hours: 8:30a- 4:00p) /1-2 Evenings are required weekly until 8 pm. Wilmington, DE Hybrid position supporting office and remote work.ChristianaCa...
  • 25 Days Ago

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Care Coordinator
  • United Medical, LLC
  • Wilmington, DE FULL_TIME
  • Care Coordinators are responsible for the follow-up and scheduling of services United Medical provides for their clients. This position acts as a liaison between patients and their physicians. Working...
  • 10 Days Ago

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Care Coordinator
  • Delaware Center for Maternal and Fetal Medicine
  • Newark, DE FULL_TIME
  • Responsibilities and Duties SPECIFIC DUTIES AND RESPONSIBILITIES: Care coordination Triage phone calls Schedule consultations Assist providers with results review Triage incoming request Communicate w...
  • Just Posted

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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) ...
  • 4/19/2024 12:00:00 AM

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Managed Care Coordinator - Referrals
  • Beth Israel Lahey Health
  • Plymouth, MA
  • **When you join the growing BILH team, you're not just taking a job, youre making a difference in peoples lives.** **Job...
  • 4/19/2024 12:00:00 AM

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Case Manager/Care Coordination Consultant
  • Boys Town
  • West Palm Beach, FL
  • Provides intensive and professional case management services to youth utilizing a strength based and comprehensive model...
  • 4/19/2024 12:00:00 AM

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Manager Care Coordination
  • hireneXus Research
  • San Francisco, CA
  • Manager Care Coordination Population Health San Francisco Bay Area Here are some of the benefits our client offers! HUGE...
  • 4/18/2024 12:00:00 AM

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Manager Care Coordination
  • Crouse Hospital
  • Syracuse, NY
  • Care Coordination is a collaborative practice model including the multidisciplinary health care team, the patient and fa...
  • 4/18/2024 12:00:00 AM

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Manager Care Coordination
  • Catholic Health Services
  • West Islip, NY
  • Overview Manager of Care Coordination (MCC) - Registered Nurse (RN) Are you exceedingly driven, dedicated, and passionat...
  • 4/18/2024 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, ...
  • 4/18/2024 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) ...
  • 4/15/2024 12:00:00 AM

Delaware is 96 miles (154 km) long and ranges from 9 miles (14 km) to 35 miles (56 km) across, totaling 1,954 square miles (5,060 km2), making it the second-smallest state in the United States after Rhode Island. Delaware is bounded to the north by Pennsylvania; to the east by the Delaware River, Delaware Bay, New Jersey and the Atlantic Ocean; and to the west and south by Maryland. Small portions of Delaware are also situated on the eastern side of the Delaware River sharing land boundaries with New Jersey. The state of Delaware, together with the Eastern Shore counties of Maryland and two co...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$49,999 to $85,806

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