Managed Care Coordinator jobs in Hilton Head Island, SC

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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Coordinator
  • Abide Home Care
  • Statesboro, GA FULL_TIME
  • Abide Home Care -

    After Hours Call Team (ACT) Coordinator

    Job Description

    The ACT Coordinator supports after hours emergency scheduling operations of Abide Home Care. This position reports to the Abide Emergency Centralized Scheduling Lead.

    Results inherent to this position (Position Statement)

    To help retain long-term quality clients and caregivers by effectively executing systems related to service inquiries, caregiver and client scheduling, after hours emergencies and other such systems that support the overall operations of Abide Home Care.

    Work Inherent In This Position

    1. Contributes to duties related to service inquiry calls including taking the initial service inquiry calls, sending information to appropriate Abide Home Care regional team and inputting information into the scheduling software.

    2. Responsible for handling and caregiver / client schedule changes by following the appropriate organizational chart for action steps.

    3. Responsible for the maintenance and accuracy of the scheduling system.

    4 . Responsible for reporting directly to the Abide ACT Lead on all the duties listed above on a weekly basis.

    5. Oversight of all office purchases, including all office supplies and other items.

    6. Responsible for coordinating all after hours scheduling activities with the caregivers and clients and tracking these updates and changes in the scheduling system.

    7. Responsible for taking initial client / caregiver emergency calls and client / caregiver complaints and reporting to the appropriate Abide Home Care regional team for further direction.

    General Standards

    1. All work will be orchestrated, documented and quantified toward the achievement of the company’s strategic objective.

    Orchestration means all routine activities will be documented and managed within the structure and context of the operations manual.

    All systems documentation will be formatted according to company templates.

    2. All work will be performed in accordance with all government laws, regulations, ordinances, and court rulings in those jurisdictions in which the company operates.

    3. All work will be performed according to company policies and standards inherent in all position contracts, action plans, employee manuals, ongoing policy memorandums, facilities and dress codes, as well as in the vision and spirit of the company’s strategic objective, company story and positioning statement.

    4. All client and employee materials and information will be held as strictly confidential outside the company. The information included in the operations manual is proprietary.

    5. All communication, both internal and external, will be returned within one business day and within two hours whenever possible.

    6. The Abide Regional Team (see company organizational chart) will be notified of any issues to be resolved or deadlines that cannot be met prior to the due date .

    7. All employee policy memorandums indicating changes in policy and / or procedure will be stored in each employee's manual until which time an updated procedure is provided.

    9. All business communications, whether verbal, visual or written, whether for internal or external use, will be professional in tone and content and according to any applicable and existing company policies and standards.

    10. Employees will respect each other’s time, space and need for concentration. Socializing and interruptions must not impede workflow.

    12. The ACT Lead will have weekly, regularly scheduled meetings with their director and / or Regional teams.

    13. Employees are encouraged to recommend ideas for the vision of the company, innovations and improvements within their department and position that are consistent with the company’s Strategic Objective.

    Innovation is encouraged and can be an ongoing process.

    04 / 27 / 2022 Company documentation is confidential and proprietary to GLAH, LLC.

    Required Qualifications

    1. Must be able to operate a computer, and software necessary to accomplish operations, including; scheduling programs, Microsoft Office Word and Excel, web browser and email.

    2. Must be able to communicate fluently and clearly, both verbally and in writing, in the language most commonly used in the workplace, which is English

    3. Must be able to meet attendance expectations, and meet deadlines.

    4. Must have a high school diploma.

    Preferred Qualifications

    1. Strong organizational, time management, and prioritization skills.

    2. Excellent communication skills and a positive attitude.

    3. Analytical and problem solving skills to take ownership and make competent decisions.

    4. Ability to work in a fast paced environment.

    5. Background in homecare, healthcare or scheduling.

    Last updated : 2024-03-28

  • 24 Days Ago

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Operations Coordinator
  • Abide Home Care
  • Richmond, GA FULL_TIME
  • Operations Coordinator Abide Home Care is a best-in-class home care provider in the State of Georgia. We are looking for a management level candidate with strong leadership and operational skills to g...
  • 26 Days Ago

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Operations Coordinator
  • Abide Home Care of Coastal Georgia
  • Richmond, GA FULL_TIME
  • Operations Coordinator Abide Home Care is a best-in-class home care provider in the State of Georgia. We are looking for a management level candidate with strong leadership and operational skills to g...
  • 23 Days Ago

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Unit Care Coordinator (Registered Nurse/RN) Agency free facility
  • Life Care Center of Hilton Head
  • Hilton Head Island, SC FULL_TIME
  • Position DetailsEmployment Status: Full-TimeShift: Day shift Position Summary The RN Unit Care Coordinator is responsible for supervising, implementing, coordinating, and managing patient care through...
  • 7 Days Ago

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RN MDS Coordinator
  • Sprenger Health Care Bluffton
  • Okatie, SC FULL_TIME
  • Qualifications: Registered Nurse, computer knowledge required, knowledge of MDS preferred, must have good organizational and follow through skills, must have good communication skills, ability to be f...
  • 1 Month Ago

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RN MDS Coordinator
  • Sprenger Health Care Systems
  • Okatie, SC OTHER
  • Job Details Job Location: SHC of Bluffton - Okatie, SC Salary Range: Undisclosed DescriptionQualifications: Registered Nurse, computer knowledge required, knowledge of MDS preferred, must have good or...
  • 1 Month Ago

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0 Managed Care Coordinator jobs found in Hilton Head Island, SC area

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Licensed Practical Nurse, Home Health Full Time
  • Humana Inc.
  • Bluffton, SC
  • Become a part of our caring community and help us put health first As a Home Health LPN, you will: * Provide professiona...
  • 4/24/2024 12:00:00 AM

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Team Member (FT & PT Storewide Opportunities) - Hilton Head Island, SC
  • Whole Foods
  • Hilton Head Island, SC
  • Are you a Foodie seeking a new and exciting opportunity? Come join the Whole Foods Market team where youll work in a pro...
  • 4/24/2024 12:00:00 AM

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cTeam Member (FT & PT Storewide Opportunities) - Hilton Head Island, SC
  • Whole Foods
  • Hilton Head Island, SC
  • Are you a Foodie seeking a new and exciting opportunity? Come join the Whole Foods Market team where youll work in a pro...
  • 4/23/2024 12:00:00 AM

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Exciting Opportunity: Storewide Team Member (FT & PT)
  • Whole Foods
  • Hilton Head Island, SC
  • Are you a Foodie seeking a new and exciting opportunity? Come join the Whole Foods Market team where youll work in a pro...
  • 4/23/2024 12:00:00 AM

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Remote Nurse Practitioner (Bilingual) Field Visits Required
  • Molina Healthcare
  • Beaufort, SC
  • JOB DESCRIPTION Job Summary The Care Connections Nurse Practitioners focus on screening and preventive primary care serv...
  • 4/22/2024 12:00:00 AM

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Lead Transportation Security Officer
  • Department Of Homeland Security
  • Hilton Head Island, SC
  • Summary Securing Travel, Protecting People - At the Transportation Security Administration, you will serve in a high-sta...
  • 4/22/2024 12:00:00 AM

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Supervisory Transportation Security Officer
  • Department Of Homeland Security
  • Hilton Head Island, SC
  • Summary Securing Travel, Protecting People - At the Transportation Security Administration, you will serve in a high-sta...
  • 4/22/2024 12:00:00 AM

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Licensed Practical Nurse, Home Health Full Time
  • CenterWell Home Health
  • Bluffton, SC
  • Become a part of our caring community and help us put health first As a Home Health LPN, you will: Provide professional ...
  • 4/21/2024 12:00:00 AM

Hilton Head Island, sometimes referred to as simply Hilton Head, is a Lowcountry resort town and barrier island in Beaufort County, South Carolina, United States. It is 20 miles (32 km) northeast of Savannah, Georgia, and 95 miles (153 km) southwest of Charleston. The island is named after Captain William Hilton, who in 1663 identified a headland near the entrance to Port Royal Sound, which mapmakers named "Hilton's Headland." The island features 12 miles (19 km) of beachfront on the Atlantic Ocean and is a popular vacation destination. In 2004, an estimated 2.25 million visitors pumped more t...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$45,763 to $78,536
Hilton Head Island, South Carolina area prices
were up 1.5% 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