Managed Care Coordinator jobs in Ohio

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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Bookeeper /Managed Care Coordinator
  • LIBERTY HEALTH CARE CENTER
  • Youngstown, OH FULL_TIME
  • Liberty Health Care Center is accepting applications for a hybrid role:

    Bookeeper/Managed Care Coordinator to work with our team of dedicated health care professionals!

    SUMMARY OF DUTIES:

    • Works with the admissions team, patient/family, and insurance companies to promote timely admissions utilizing appropriate precertification process in order to maximize patient benefits
    • Pre-certification of admissions/ readmissions
    • Daily updates with insurance companies
    • Insurance appeals, payment appeals and communication with UR team
    • Schedule all resident transportation including insurance information and prior authorizations as needed
    • Cancel transportation as needed and communicate changes to family members
    • Review and verify ambulette/ambulance billing.
    • Primarily responsible to provide bookkeeping and secretarial support within the nursing facility.
    • Includes, but not limited to establishing and maintaining payment resources, guardian documents, and resident trust funds.

    REQUIREMENTS:

    • Minimum 1-2 years healthcare, experience preferred and experience with progressive responsibility in the healthcare environment
    • Critical thinking skills, decisive judgment, and the ability to work with minimal supervision meeting firm deadlines
    • Assertive and persuasive and creative communication and negotiation skills, action oriented
    • Excellent skills in communication both verbal and written documentation
    • Interpersonal relations
    • Organizational Skills
    • Ability to develop and maintain rapport with the insurance provider, patient, families, and the interdisciplinary team.
    • one-year experience in long-term care billing with a working knowledge of Medicare, Medicaid, PPS, Managed Care Organizations, and private insurance.

    EDUCATION:

    • Associates degree preferred in AR, accounting, billing, clerical, or related field.

    Windsor House offers a competitive benefit package:

    • NEW College Loan Payoff Program for RNs & LPNs!*
    • $1.00 an Hour Attendance Bonus on every hour worked paid quarterly!
    • Performance Based Annual Bonus Plan.
    • Tuition Reimbursement for LPN or RN programs available.
    • Multiple health coverage offerings to choose from.
    • Vision.
    • Company-paid and Supplemental Life Insurance.
    • 401K.

    Locally, family owned and operated. Come Join our Team and be part of the Tradition of Caring that Windsor House, Inc. has been providing for over 60 years!

    Consider joining our team of dedicated medical professionals committed to providing the best quality of care to those most vulnerable members of our communities.

    Job Type: Full-time

    Location: 1355 Churchill-Hubbard Road 44505

    Phone: 330-759-7858

    Job Type: Full-time

    Benefits:

    • 401(k)
    • 401(k) matching
    • Dental insurance
    • Health insurance
    • Paid time off

    Schedule:

    • Monday to Friday

    Ability to Relocate:

    • Youngstown, OH 44505: Relocate before starting work (Required)

    Work Location: In person

  • 1 Day Ago

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Associate Counsel - Managed Care
  • Cleveland Clinic
  • Beachwood, OH FULL_TIME
  • Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At C...
  • 22 Days Ago

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Managed Care Nurse Staff
  • Western & Southern Financial Group
  • CINCINNATI, OH FULL_TIME
  • Overview Summary of Responsibilities: Provides concurrent and retrospective utilization reviews, large case management, disability case management and other programs to improve the quality of medical ...
  • 4 Days Ago

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Managed Care Biller
  • CommuniCare Family of Companies
  • Cincinnati, OH FULL_TIME
  • Managed Care BillerDue to Company growth, CommuniCare Health Services is currently recruiting a Managed Care Biller for our Corporate Managed Care Billing Department.PURPOSE/BELIEF STATEMENTThe positi...
  • 8 Days Ago

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Managed Care Biller
  • CommuniCare Family of Companies
  • Cincinnati, OH FULL_TIME
  • Managed Care BillerDue to Company growth, CommuniCare Health Services is currently recruiting a Managed Care Biller for our Corporate Managed Care Billing Department.PURPOSE/BELIEF STATEMENTThe positi...
  • 8 Days Ago

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Managed Care Biller
  • CommuniCare Family of Companies
  • Blue, OH FULL_TIME
  • Managed Care BillerDue to Company growth, CommuniCare Health Services is currently recruiting a Managed Care Biller for our Corporate Managed Care Billing Department.PURPOSE/BELIEF STATEMENTThe positi...
  • 1 Month Ago

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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...
  • 4/26/2024 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) ...
  • 4/25/2024 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...
  • 4/25/2024 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) ...
  • 4/24/2024 12:00:00 AM

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RN Utilization Management Managed Care Coordinator
  • Professional Management Enterprises
  • Columbia, SC
  • Job Description Job Description Seeking an RN with Managed Care and Utilization Management experience to review and eval...
  • 4/24/2024 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...
  • 4/23/2024 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, ...
  • 4/23/2024 12:00:00 AM

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RN - Registered Nurse Case Manager - Care Coordination
  • Geisinger
  • Olyphant, PA
  • Job Title: RN - Registered Nurse Case Manager - Care Coordination Location: Wilkes-Barre, Pennsylvania Job Category: RN ...
  • 4/22/2024 12:00:00 AM

Ohio /oʊˈhaɪoʊ/ (listen) is a Midwestern state in the Great Lakes region of the United States. Of the fifty states, it is the 34th largest by area, the seventh most populous, and the tenth most densely populated. The state's capital and largest city is Columbus. The state takes its name from the Ohio River, whose name in turn originated from the Seneca word ohiːyo', meaning "good river", "great river" or "large creek". Partitioned from the Northwest Territory, Ohio was the 17th state admitted to the Union on March 1, 1803, and the first under the Northwest Ordinance. Ohio is historically know...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$48,177 to $82,678

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