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)
About the job
HME Specialists is a fast growing primary player in NM providing Durable Medical Equipment, Home Infusion and LTC/Hospice services
The Director of Managed Care & Contracting will oversee strategy and development for all Managed Care Services and Contracting for the LTC and New Vista lines of business. The Corporate Director is responsible for full managed care contract life-cycle support, including new business and revenue development through continued clinical integration and market expansion.
Job duties & responsibilities
Knowledge/Skills/Abilities
Experience