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)
Hospital Sisters Health System is recruiting for their next Vice President of Managed Care. This role is responsible for the managed care portfolio within the HSHS System. This role reports directly to the HSHS SVP & Chief Financial Officer and is based at our system office in Springfield, IL.
The ideal candidate is a seasoned financial leader in healthcare with specific experience with a managed care portfolio at a system level. The ideal candidate is also experienced in managed care negotiations at a system level as well.
Minimum Requirements:
Benefits:
HSHS has comprehensive benefit package designed exclusively for executive leaders. A variety of medical/dental/vision offerings along with unlimited time off, annual compensation incentive, relocation package, and robust retirement plan are just a few of our exciting offerings.
HSHS Information:
Throughout communities in Illinois and Wisconsin, 13 hospitals, numerous community-based health centers and clinics, our 13,000 colleagues have built a culture based on our solid core values of respect, care, competence, and joy. These are the ideals we believe in, work by, and live each day.
Built upon more than 145 years of service to the communities we serve, we now look to the future and our place in it as a health care system that strives to continually improve processes, procedures, and outcomes with the latest and most advanced technologies and treatments. Regardless of how far our passion for excellence carries us, our focus will always remain on the most important person in our entire organization: The patient.