Managed Care Coordinator jobs in Tennessee
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)
Recently Added Managed Care Coordinator jobs
Managed Care Specialist
- Software Technology Inc
-
Nashville, TN
FULL_TIME
-
Job Title: Managed Care Specialist
Location: Nashville, TN/Hybrid - Candidate Must Be Local
Duration: 6 months
Work Type- Hybrid
TennCare will recruit a new classification for MANAGED CARE PROGRAM MGR.
This Contractor position is critical to accomplishing LTSS ID Services Team outcomes related to ensuring that the 1915(c) and Select Community programs are operating at maximum performance and ensuring that upcoming federal reporting and waiver renewal/amendment deadlines are met. The Contractor is needed to assist the ID Services Team in conducting continuous analysis and evaluation of frequent and recurring reports/deliverables/related contract amendments in efforts to enhance program improvement, complete 1915(c) post-payment Utilization Reviews, update/analyze/validate federally mandated 1915(c) quality data on a monthly basis, and perform careful review and contribution to the upcoming 2025 1915(c) waiver renewals.
MINIMUM QUALIFICATIONS
- Graduation from an accredited college or university with a bachelor's degree and experience equivalent to 3 years of professional level experience.
- Excellent Excel skills and experience with all other Microsoft Office Programs.
- Experience interpreting policy or procedural provisions for a TennCare, Medicaid, or other related health insurance organization is preferred.
- Excellent written and oral communication skills
- Passion and commitment to supporting people with I/DD, person-centered practices, and integrated employment and community living
- Experience with program management and/or grant management
- Experience in contract management
- Experience working in or with Medicaid or disability related programs
- Strong work ethic and self-motived with ability to work well on a team
- Organizational skills, including the ability to prioritize, multi-task and manage workload to meet specific timeframes and deadlines
- Ability to adapt to changing priorities and deadlines
- 5 Days Ago
Managed Care Specialist
- Amtex Systems Inc.
-
Nashville, TN
FULL_TIME
- Amtex Systems Inc is an information technology and talent solutions company offering talent and BI consulting to the companies in US for over 20 years.Our solutions are designed to fill resource gaps,...
- 5 Days Ago
Managed Care Program manager
- Stellar Professionals
-
Nashville, TN
CONTRACTOR
- MANAGED CARE PROGRAM MGR.This Contractor position is critical to accomplishing LTSS ID Services Team outcomes related to ensuring that the 1915(c) and Select Community programs are operating at maximu...
- 8 Days Ago
Managed Care Specialist
- Anveta, Inc
-
Nashville, TN
CONTRACTOR
- Hi Team,Candidate Must Be LocalManaged Care SpecialistLocation: Tennessee 37128--(Onsite)Duration: 6 MonthsResponsibilitiesJob Description Determine individual and family eligibility for our Client’s ...
- 9 Days Ago
Managed Care Specialist
- MY3TECH INC
-
Nashville, TN
CONTRACTOR
- Job: Managed Care Specialist Job ID: 62808 Location : 310 Great Circle Rd. Nashville, Tennessee 37243-0000 Consultants pay rate: $21 /hr on W2 (All Inclusive) TennCare will recruit a new classificatio...
- 11 Days Ago
Managed Care Specialist
- Intellibee Inc
-
Nashville, TN
CONTRACTOR
- DESIRABLE QUALIFICATIONS Passion and commitment to supporting people with I/DD, person-centered practices, and integrated employment and community living Experience with program management and/or gran...
- 11 Days Ago
Managed Care Coordinator jobs at Popular Companies
Managed Care Coordinator
- Mindlance
-
Columbia, SC
- Job Title: Managed Care Coordinator Job Location: Columbia, SC Top 3/5 Skills: · RN / Registered Nurse License · Chronic...
- 6/11/2024 12:00:00 AM
Managed Care Coordinator
- MJHS
-
New York, NY
- Req #: 1509 Job ID: 13084 Job Location: New York, NY Zip Code: 10040 Category: Office and Administrative Support Agency:...
- 6/10/2024 12:00:00 AM
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) ...
- 6/9/2024 12:00:00 AM
Sales Manager/ Care Coordinator
- Always Best Care Senior Services
-
Thousand Oaks, CA
- Sales Manager / Care Coordinator Always Best Care, a National home care company, is currently looking for a seasoned, en...
- 6/9/2024 12:00:00 AM
Managed Care Coordinator - Foster Care
- Elevance Health
-
Radford, VA
- Description The Foster Care Managed Case Manager is responsible for overall management of member's individual service pl...
- 6/9/2024 12:00:00 AM
Credentialing and Managed Care Coordinator
- Texas Oncology
-
Richardson, TX
- Overview: The US Oncology Network is looking for a Credentialing and Managed Care Coordinator to join our team at Texas ...
- 6/8/2024 12:00:00 AM
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) ...
- 6/8/2024 12:00:00 AM
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, ...
- 6/7/2024 12:00:00 AM
About Tennessee
Tennessee borders eight other states: Kentucky and Virginia to the north; North Carolina to the east; Georgia, Alabama, and Mississippi on the south; Arkansas and Missouri on the Mississippi River to the west. Tennessee is tied with Missouri as the state bordering the most other states. The state is trisected by the Tennessee River.
The highest point in the state is Clingmans Dome at 6,643 feet (2,025 m). Clingmans Dome, which lies on Tennessee's eastern border, is the highest point on the Appalachian Trail, and is the third highest peak in the United States east of the Mississippi River. The ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$45,795 to $78,595
Most Popular Cities in Tennessee for Managed Care Coordinator Jobs
What does a Managed Care Coordinator do?
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