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)
We are, and always will be, dedicated to improving the health of Native Hawaiians and all of the people of Hawai‘i.
The Queen’s Health System began with a single hospital in 1859 founded by Queen Emma and King Kamehameha IV to provide health care and healing. We now have four hospitals and more than 70 preventive, specialty health care locations and labs throughout the Pacific region.
Our caregiver team includes more than 8,000 employees and over 1,400 physicians networked throughout Hawai‘i and the Pacific Basin.
We’re collaborators who care. We listen to and learn from each other to ensure that our patients benefit and our communities blossom.
If this sounds like an ideal place for your career to grow, we hope you’ll join our ‘ohana!
I. JOB SUMMARY/RESPONSIBILITIES:
II. TYPICAL PHYSICAL DEMANDS:
III. TYPICAL WORKING CONDITIONS:
IV. MINIMUM QUALIFICATIONS:
A. EDUCATION/CERTIFICATION AND LICENSURE:
B. EXPERIENCE:
Equal Opportunity Employer / Disability / Vet
Job Type: Full-time
Pay: $61,649.00 - $75,520.00 per year
Benefits:
Schedule:
Ability to Relocate:
Work Location: In person