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)
Job Description: Under the supervision of the Executive Director, the RMP Coordinator is responsible for all aspects of the community development in the managed retreat and relocation of the community. Primarily responsible for developing, proposing, and implementing projects. Maintains frequent contact with the elected and appointed officials. Prioritize and plan cultural, governmental, natural resources, health, transportation, housing and relocation for the Tribal community.
**Supervisory Requirements**
This job has supervisory responsibilities.
**Responsibility**
-Facilitate and support Tribal leadership in identifying opportunities, initiatives, and potential partners to further community development.
-Implementation of master planning, engineering designs, and construction operations involved in new infrastructure and/or reinforcement of current critical infrastructure, shoreline stabilization, assist with activities that may involve excavation, backfill, and other activities associated with heavy equipment.
- Develop and update Tribal and community development profiles.
-Develop partnerships with appropriate state, local and federal agencies.
-Establish and maintains cooperative working relationships with outside agencies, businesses, and municipal developers providing overall project coordination.
-Thorough knowledge of the principles and practices of civil engineering as applied to land development and infrastructure management.
-Ability to plan, lay out and direct the work of subordinates.
-Ability to inspect projects for compliance with ordinance and code provisions.
-Ability to perform difficult engineering computations and to make thorough recommendations on engineering problems and planning.
-Include planning and promoting economic development in coordination with Tribal enterprises and engineering problems and planning.
-Prepare, or assist in preparations, proposals for funding to support community development, planning, or other related programs.
-Promote Tribal interests to support and expand Tribal services and/or governmental function opportunities.
-Attend regional, state, and national meetings and conferences on community and Tribal development planning.
-Develop and maintain community and regional networks to enhance Tribal government services and service delivery to Tribal members.
-Serve as liaison to external government, consulting firms, and other entities to support improvements in Tribal services and government operations.
-Monitor current budgets and work with Chief Financial Officer, Tribal administration, bookkeepers, and/or budget coordinators, as well as any Community Development Staff to develop fiscal budgets.
-Other duties as Assigned.
**Qualifications**
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill and/or ability required. Reasonable accommodation may be made to enable individuals with disablities to perform the essential functions.
**Work Experience**
Process exceptional writing and editorial skills with the ability to communicate the goals and aims of the Tribe to outside funding sources in a manner that invites successful funding of agency requests. Maintain a high level of activity within daily supervision to develop project plans and consistently meet deadlines. Aptitude to develop creative approaches to insure that affected agency projects can be developed which also meets requirements of funding sources. Strong analytical skills and attention to detail are required. Must have the ability to work and write professionally in a deadline-driven environment. Significant experience in Tribal Government, program management, and compliance with Federal grant requirements. Knowledge and sensitivity and the ability to communicate effectively with staff, Council, Federal, outside agencies Tribal officials, Native Americans and non-Indians. Knowledge of Tribal government, infrastructure, ordinances, laws and policies.
**Computer Skills**
Proficiency in Microsoft Office applications required. Knowledge of GIS mapping, design and engineering programs, Adobe, and other related applications is preferred.
**Language Skills**
Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures, and government regulations.
**Mathematical Skills**
Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical solutions is required; Ability to work with mathematical concepts such as probability and statistical inference is preferred.
**Competencies**
**Physical Demands**
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 accomodations may be made to enable individuals with disabilities to perform the essential functions.
**Work Environment**
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job within the Tribal Government. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential.
Job Types: Full-time, Contract, Temporary
Pay: $43,505.37 - $52,393.57 per year
Benefits:
Weekly day range:
Work setting:
Ability to Commute:
Ability to Relocate:
Work Location: In person