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)
External Description
Interface with physicians, AVS staff (Nurses, Adaptive Equipment Specialist, Motor Development Specialist, PT, OT, ST, & Administrators), Durable Medical Equipment vendors, pharmacy, etc.
to obtain documentation, facilitate billing and coordinate follow-up.
Earn between $ -
Benefits
Merakey offers medical, dental - vision insurance plans, competitive compensation plans and more!
About Merakey
Merakey is a non-profit provider of developmental, behavioral health, and education services. More than 8,000 employees provide support to nearly 40,000 individuals and families throughout 12 states across the country each year.
Merakey strictly follows a zero-tolerance policy for abuse.
Merakey is proud to be an Equal Opportunity Employer! We deeply value diversity and do not discriminate on the basis of race, religion, color, national origin, ethnic background, sex, gender, gender identity, sexual orientation, age, marital status, veteran status, genetic information, or disability status.
Moreover, we are committed to creating teams that reflect the diversity of the communities we serve and encourage applicants from underrepresented backgrounds to apply.
Merakey welcomes all Veterans to apply!
Requirements
Must be familiar with the managed care field, computer literate or able to learn Microsoft Office.
Last updated : 2024-05-31