Managed Care Coordinator jobs in Illinois

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)

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Managed Care Specialist
  • USA Vein Clinics, Vascular, Fibroid and Oncology Centers
  • Chicago, IL FULL_TIME
  • The Managed Care Specialist partners with the Manager of Contracting and Payor Relations on the implementation of payor strategy, focusing on payor operations, client services, and process improvement. This role ensures resolution of payor issues received from the field, leadership, or other internal departments, tracking of opportunities, and continual documentation and improvement of processes.

    Responsibilities

    • Assist with implementation of payor strategy in partnership with the Manager of Contracting and Payor Relations.
    • Maintains a thorough operational knowledge of contractual agreements and specific contractual language with Payors.
    • Collaborate with credentialing regarding demographic updates and needs related to contracting efforts.
    • Collaborates with Operations, legal, billing, and compliance to track and resolve payor issues, including payment and/or billing disputes.
    • Continually create, document, and improve processes to provide clear communication throughout the lifecycle of contracting efforts.
    • Determine and implement any tools or technology required to assist in providing communication and updates to leadership and other relevant stakeholders.
    • Manages contract assignments and any documentation relevant to the negotiation, strategy, and/or implementation of the contract.
    • Proactively monitor and report current contracting efforts.
    • Partner with internal team to ensure that contracting efforts align with company and divisional goals.
    • Communicate with relevant stakeholders to ensure contract commitments are operationalized.
    • Performs various tasks assigned related to contracting.
    • Additional duties as assigned
  • 6 Days Ago

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Managed Care Specialist
  • USA Vein Clinics, Vascular, Fibroid and Oncology Centers
  • Northbrook, IL FULL_TIME
  • The Managed Care Specialist partners with the Manager of Contracting and Payor Relations on the implementation of payor strategy, focusing on payor operations, client services, and process improvement...
  • 1 Day Ago

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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Chicago, IL FULL_TIME
  • We are currently seeking a skilled and motivated Pharmacist with expertise in Pharmacy Benefit Management (PBM) and Managed Care. In this pivotal role, you will be responsible for overseeing medicatio...
  • 23 Days Ago

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Managed Care Manager
  • Clinical Management Consultants
  • Auburn, IL FULL_TIME
  • If you are a Managed Care Manager looking to take the next step forward in your career, then this is the ideal opportunity for you! A vast healthcare network in dynamic Illinois is actively looking fo...
  • 25 Days Ago

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Member service representative
  • Managed Care Staffers
  • Alsip, IL FULL_TIME
  • You must have at least 3 years of pens... Last updated : 2024-06-05
  • 4 Days Ago

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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

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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

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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

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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

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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

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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

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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

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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

Illinois (/ˌɪlɪˈnɔɪ/ (listen) IL-ih-NOY) is a state in the Midwestern and Great Lakes region of the United States. It has the fifth largest gross domestic product (GDP), the sixth largest population, and the 25th largest land area of all U.S. states. Illinois is often noted as a microcosm of the entire United States. With Chicago in northeastern Illinois, small industrial cities and immense agricultural productivity in the north and center of the state, and natural resources such as coal, timber, and petroleum in the south, Illinois has a diverse economic base, and is a major transportation hu...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$50,592 to $86,828

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