Managed Care Coordinator jobs in Florida
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 Coordinator
- Florida Medical Clinic Orlando Health
-
Dade, FL
FULL_TIME
-
Our Vision is to be the best choice for healthcare in our community
This posting is for a FULL-TIME Managed Care Coordinator within our Family Practice office in Dade City. This role is responsible for assisting providers, supervisors, and staff members with all aspects of the managed care plans. Qualified candidates must have a strong understanding of Medicare insurances and Excel spreadsheets, medical terminology. Five years of experience in a similar role preferred. Medical Assistant background a plus.
WHAT DOES FLORIDA MEDICAL CLINIC ORLANDO HEALTH HAVE TO OFFER ITS EMPLOYEES?
We offer a wide choice of compensation and benefit programs that are among the best. From competitive salaries to retirement plans. We make every effort to take care of the people who make our company great.
Gives you an employer that you will have pride in working for
Provides excellent training programs and opportunities for growth
Offers Medical Benefits including:
Employer Contributions to HSA high deductible plan
Discounts at our medical facilities
Cigna Open Access OAPIN & OAP plans
Supports Incentive based Wellness Programs
Offers company sponsored Life Insurance with buy-up provisions
Provides Dental, Vision, Long and Short Term Disability, Accident & Illness policy options
Supports Paid Time Off and Holidays
Gives generous 401K plan with annual 3% Employer contribution after one year of employment
Values and appreciates its employees
Boasts a reputation for superior health care and quality service
Job Qualifications:
High school graduate or GED
Strong customer service orientation
Time management and multitasking
Organize and manage multiple priorities
Computer proficiencies
Strong team player
Maintains MRA data as required by Managed Care Carriers
Reviews and completes managed care report; suspect, Hedis , Prostar.
Updates the Plan Code Audit for center
Normal physical ability; able to sit for long periods
Normal concentration and normal complexity of decision making
High level verbal and written communication skills
Keys to Success in this Role:
Essential Functions of the Position:
Acts as Case Manager
Obtains approval from the provider for requested authorizations
Coordinates visits
Notifies patients of the appointments
Forwards clinical data to the treating provider and/or facility
Notifies specialist office and patient of denied requests for authorization
Uses approved web tools to obtain authorizations
Reviews hospital census daily and distributes information to supervisors
Coordinates admissions with providers and facilities
Assists with coordination of care for patient
Assist in managing care for Out of State patients
Assists with complicated referrals for Home Health, DME and denials
Physician Staff Support
Train new providers on play polices, MRA, Hedis.
Updates providers and staff on changes in referral process, MRA and Part D coverage.
Inputs providers into Practice Management.
Works with supervisors and staff to promote team work.
Maintains MRA data as required by Managed Care Carriers
Submits claim encounters
Reviews and completes managed care reports; suspect, Hedis reports and updates Estar.
Addresses and handles all tasks in a timely manner
Coordinates meetings between providers/Medical Directors
Prepares agenda
Types minutes of meetings
Follows through on all requests by providers.
Provides reports to CFO (center totals, membership)
Handles and returns referral related calls
Additional Responsibilities:
Maintains an organized and clean work area
Participates in maintenance of office supplies
Performs other incidental and related duties as required and assigned
Physical and Mental Demands:
Routine desk and office activities
Ability to move frequently throughout the facility and to sit for long periods of time
High level verbal and written communication skills
Above average ability to manage multiple tasks and projects simultaneously
We are an Equal Opportunity Employer and make employment decisions without regard to race, gender, disability or protected veteran status
#IND123 - 4 Days Ago
Managed Care Coordinator
- All County Staffing Dade
-
Miami, FL
FULL_TIME
- Job Summary: We are seeking a highly organized and detail-oriented individual to join our team as a Patient Care Coordinator. As a Patient Care Coordinator, you will play a crucial role in providing a...
- 2 Months Ago
MANAGED CARE COORDINATOR - HYBRID - TOC CLINIC MAIN
- Florida Orthopaedic Institute
-
Tallahassee, FL
FULL_TIME
- In This Role You WillBe responsible for all aspects of the credentialing, re-credentialing and privileging processes for all medical providers who provide patient care at Florida Orthopaedic Institute...
- 1 Day Ago
MANAGED CARE COORDINATOR - HYBRID - TOC CLINIC MAIN
- Florida Orthopaedic Institute
-
Tallahassee, FL
OTHER
- Job Details Job Location: TOC Clinic Main - Tallahassee, FL Position Type: Full Time Education Level: High School Salary Range: Undisclosed Travel Percentage: None Job Shift: Day DescriptionIn this ro...
- 1 Month Ago
MANAGED CARE COORDINATOR - HYBRID - NORTH TAMPA
- Florida Orthopaedic Institute
-
Tampa, FL
OTHER
- Job Details Job Location: North Tampa Office - Tampa, FL Position Type: Full Time Education Level: High School Salary Range: Undisclosed Travel Percentage: None Job Shift: Day DescriptionIn this role ...
- 2 Months Ago
Managed Care Data Analyst
- Sarasota Memorial Health Care System
-
Sarasota, FL
FULL_TIME
- Job DescriptionDepartmentManaged CareJob SummaryWorks with Managed Care Analyst Sr to oversee the balancing, reconciling, and resolution of errors for the daily 835 and 837 files, charges, payments, a...
- 7 Days Ago
Managed Care Coordinator jobs at Popular Companies
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, ...
- 6/12/2024 12:00:00 AM
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-Onsite Kansas City
- AdventHealth
-
Maitland, FL
- **AdventHealth -** **This position is in Kansas City** **All the benefits and perks you need for you and your family:** ...
- 6/10/2024 12:00:00 AM
Care Management, Care Coordinator, Utilization Management
- Hackensack Meridian Health
-
Neptune, NJ
- Description: Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients ...
- 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
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
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
About Florida
Florida (/ˈflɒrɪdə/ (listen); Spanish for "land of flowers") is the southernmost contiguous state in the United States. The state is bordered to the west by the Gulf of Mexico, to the northwest by Alabama, to the north by Georgia, to the east by the Atlantic Ocean, and to the south by the Straits of Florida. Florida is the 22nd-most extensive (65,755 sq mi or 170,300 km2), the 3rd-most populous (21,312,211 inhabitants), and the 8th-most densely populated (384.3/sq mi or 148.4/km2) of the U.S. states. Jacksonville is the most populous municipality in the state and the largest city by area in th...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$46,982 to $80,632
Most Popular Cities in Florida 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