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)
Join our Team!
Community Options has an exciting opportunity within the Behavioral Health Department in the Clinical Division as a Care Coordinator. This position works to establish working relationships with clients to develop care plans and coordinate support with other service providers by making appropriate referrals to internal and external resources and provide follow-up to ensure client’s goals are met. This role is responsible for completing intakes, assessing the needs, and developing care plans to help clients overcome barriers and become independent.
Who are we?
Community Options is a statewide organization with ten offices across North Dakota and countless programs tailored to individuals. Through our person-centered approach, we can assist many people to recognize their potential.
Community Options works with individuals from all walks of life. Through our person-centered approach we offer support services to aid people who have experienced:
Why Community Options?
The salary for this position is $18- $20 an hour depending on experience (DOE).
Minimum Qualifications:
Reporting to this position: None
Physical Demands and Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation(s) may be made to enable qualified individuals with disabilities to perform the essential functions.
• Physical Demands: While performing the duties of this job, employees are required to have the ability to climb (stairs), balance, stoop, kneel, crouch, reach (above shoulder), bend, twist, sit, stand, walk, push, pull, lift, grasp, fine motor manipulation, talk, hear, and complete repetitive motions; swimming may be required. Must occasionally lift and/or move objects weighing up to 50 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. Employees may be subject to working with customers that exhibit behaviors that would require the employee to use possible physical de-escalation techniques.
• Work Environment: Employees work in indoor and/or outdoor environments, i.e., office, home, or community setting. Employees are required to operate a motor vehicle and travel as deemed necessary. Assigned work shifts and locations will vary depending on the customers’ and/ or agency needs.
NOTE: The duties listed are not intended to be all-inclusive. Responsibilities assigned to any individual employee are at the discretion of the appointing authority.
The employee is expected to adhere to all department policies and to act as a role model in the adherence to policies.
Community Options exists to help people live individually and be active in their community.
Equal Employment Opportunity
Community Options does not discriminate on the basis of race, color, national origin, sex, genetics, religion, age or disability in employment or the provisions of services and complies with the provisions of the North Dakota Human Rights Act