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)
USA Managed Care Organization is looking for an enthusiastic person that loves to help others. You will be answering calls and providing assistance to callers who are looking for medical providers and facilities for multiple companies. As time permits, will also update provider records. If you are outgoing and reliable with a pleasant personality, we want to hear from you!
Job Responsibilities:
Qualifications:
Physical Requirements:
Requires sight and mobility to effectively operate various office machinery including but not limited to computers, telephone, copier, etc. Must also be able to stand or sit for long periods throughout the day. Computer/keyboard activity averages over 2/3 of time each day. Sight requirements include close (clear vision at 20 inches or less), distance (clear vision at 20 feet or more), and ability to adjust the eyes to bring an object into sharp focus. These requirements result from the demands of reading reports, information and working with computers. Talking/hearing activity averages over 2.3 of time each day.