Managed Care Coordinator jobs in the United States

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 Managed Care - Remote
  • McLaren Health Care Corp
  • Auburn, MI FULL_TIME
  • About Us

    McLaren Health Care is a fully integrated health network committed to quality, evidence-based patient care with locations in Michigan and Indiana. The McLaren system includes 13 hospitals in Michigan, ambulatory surgery centers, imaging centers, a primary and specialty care physician network, commercial and Medicaid HMOs, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, one of only 53 National Cancer Institute-designated comprehensive cancer centers in the U.S.

    Coordinator Managed Care - Remote

    Michigan, Auburn Hills

    NEW

    Non-Health Professional

    McLaren Health Care Corp

    24002931


    We are looking for a Managed Care Coordinator to join us in leading our organization forward.

    McLaren Health Care is one of Michigan's fastest growing health systems. With 15 hospitals, annual revenues of over $6 billion, and a service area that covers 75% of the state of Michigan, McLaren is committed to the highest levels of patient care.

    McLaren Physician Partners is a joint venture partnership between the McLaren healthcare System and our Physician members. Our focus is to support physician offices in all aspects of care delivery and operations including clinical integration, contracting, quality, care coordination and care management, across all settings.

    Position Summary:
    Responsible for implementing, operationalizing and administration of third-party payor/Managed Care agreements within all market segments for McLaren Physician Partners (MPP), McLaren Health Care Corporation (MHCC), McLaren High Performance Network (MHPN) and its subsidiaries. Assist and support of the relationships with Health Plans and third-party payors. Coordinate and facilitate education of hospitals, physicians and staff relative to the operational, payment, quality programs and initiatives specific to each third-party payor, leads JOCs and resolution of issues as they may develop. Conducts contract modeling and analysis with an understanding of population health and value-based contracting. Professionally and effectively communicates the advantages of contracting with McLaren, provides ongoing support to the contract management team.
    This is a fully remote position.

    Equal Opportunity Employer of Minorities/Females/Disabled/Veterans

    #LI-AK1

    QUALIFICATIONS:
    Required:
    • Bachelor’s Degree in business, health care or related field.
    • Two years’ experience in a Managed Care organization, Health Plan, PHO, PO or similar organization.
    Preferred:
    • Experience with standard and innovative contract and reimbursement methodologies, including but not limited to fee for service, value-based payments, risk contracting, capitation and bundled payments.
    • Master’s degree in health care management, Finance or related field.
    • Five (5) years’ experience in provider contracting and servicing.
    • Established relationships with Health Plans, other Industry Professionals.

    Additional Information

    • Schedule: Full-time
    • Requisition ID: 24002931
    • Daily Work Times: 8:00 am - 5:00 pm
    • Hours Per Pay Period: 80
    • On Call: No
    • Weekends: No
    McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status, national origin, disability, genetic information, height or weight, protected veteran or other classification protected by law.
  • 13 Days Ago

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Managed care coordinator
  • Fresenius Medical Care Holdings, Inc.
  • Franklin, TN FULL_TIME
  • PURPOSE AND SCOPE : Responsible for successful implementation, coordination, and administration of contracting and pricing procedures. This includes contract terms and conditions, products and prices ...
  • 1 Day Ago

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Managed care coordinator
  • Fresenius Medical Care Holdings, Inc.
  • Franklin, NC FULL_TIME
  • PURPOSE AND SCOPE : Responsible for successful implementation, coordination, and administration of contracting and pricing procedures. This includes contract terms and conditions, products and prices ...
  • 2 Days Ago

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Managed Care Compliance Coordinator
  • St Vincents Services Inc
  • Brooklyn, NY FULL_TIME
  • Under the supervision of the Director of Health and Wellness, the Managed Care Compliance Coordinator is part of the Medicaid Managed Care Liaison team. This team is responsible for ensuring that HSVS...
  • 13 Days Ago

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Managed Care Compliance Coordinator
  • HEARTSHARE HUMAN SERVICES OF NEW YORK
  • Brooklyn, NY OTHER
  • Job Details Job Location: 66 Boerum Place, 66 Boerum Place, Brooklyn, NY, 11201 - Brooklyn, NY Position Type: Full-Time Education Level: Bachelors Degree or Equivalent Salary Range: $50,000.00 - $55,0...
  • 14 Days Ago

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Managed care coordinator
  • Mindlance
  • Columbia, SC FULL_TIME
  • Job Title : Managed Care Coordinator Job Location : Columbia, SC Top 3 / 5 Skills : RN / Registered Nurse License Chronic condition care Case Management Job Responsibilities Reviews and evaluates medi...
  • Just Posted

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Addiction Counselor-LI (Remote Opportunity)Telehealth Behavioral Health
  • NYC Health + Hospitals
  • Columbus, OH
  • About NYC Health + Hospitals: Lincoln Medical and Mental Health Center is one of New York City’s premier acute care hosp...
  • 5/19/2024 12:00:00 AM

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LPN Care Coordinator | Office Setting | Outpatient Internal Medicine ($3,000 sign-on bonus)
  • Memorial Hospital Union County
  • Marysville, OH
  • $3,000 Sign-On Bonus We are looking for an LPN to join our Internal Medicine Team as a Care Coordinator! What You'll Do:...
  • 5/19/2024 12:00:00 AM

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Primary Care Physician
  • ChenMed Careers
  • Columbus, OH
  • Were unique. You should be, too. Were changing lives every day. For both our patients and our team members. Are you inno...
  • 5/19/2024 12:00:00 AM

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Home Health Registered Nurse (RN) West Columbus
  • PURPOSE HOME HEALTH
  • Columbus, OH
  • Home Health Registered Nurse Are you searching for a Purpose? PurposeCare is Bringing Healthcare Home, and we want you t...
  • 5/19/2024 12:00:00 AM

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Medical Assistant as Health Coach Care Coordinator
  • Prescribe Fit LLC
  • Columbus, OH
  • Job Description Job Description Engaging with our clients’ life story begins with their healthcare provider. Prescribe F...
  • 5/18/2024 12:00:00 AM

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PCC - General Offices
  • Sonrava Health
  • Columbus, OH
  • Overview: Our company is looking for a bright, motivated and talented Patient Care Coordinator. The Patient Care Coordin...
  • 5/16/2024 12:00:00 AM

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Remote - Enrollment Specialist - Sales
  • CareHarmony
  • Columbus, OH
  • CareHarmony is a venture-backed start-up; formed to help physicians thrive in the new era of value-based care by combini...
  • 5/16/2024 12:00:00 AM

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Patient Service Representative - Care Coordinator
  • quantum-health
  • Dublin, OH
  • Description Now Hiring For June Classes! Starting Pay: Minimum $18.00 - Maximum $24.00 per/hour* Shift Differential: + $...
  • 5/15/2024 12:00:00 AM

Income Estimation for Managed Care Coordinator jobs
$49,355 to $84,702