Managed Care Coordinator jobs in Wisconsin

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 Coordinator
  • Family Health Center of M
  • Neillsville, WI FULL_TIME
  • The Managed Care Coordinator completes insurance requirements and provides case management as needed for services performed in various patient seeing settings. The individual obtains and provides insurance benefit information to patients and patient care departments. The Managed Care Coordinator assists patients and providers with developing strategies for alternative options for non-covered services by communicating with the provider, patient, insurance carrier and Patient Assistance Counselor.

    JOB QUALIFICATIONS 

    EDUCATION

    For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation.

    Minimum Required: High school diploma or equivalent. Successful completion of a medical terminology and an anatomy & physiology course, per departmental procedures, within one year of hire.

    Preferred/Optional: Successful completion of a medical terminology and an anatomy & physiology course at time of hire. Graduate of a Medical Assistant, Health Unit Coordinator or Health Care Business Service program.

    EXPERIENCE

    Minimum Required: Two years’ experience in a medical business office or health care setting. Prior experience should include working with and obtaining insurance eligibility and benefit information.

    Preferred/Optional: None

    CERTIFICATIONS/LICENSES

    The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position.

    Minimum Required: For positions hired within the dental centers: Basic Life Support (BLS) awarded by the American Heart Association within one year of hire.

    Preferred/Optional: Basic Life Support (BLS) awarded by the American Heart Association at time of hire.


    Monday-Friday 8-5
    40
  • 1 Day Ago

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Managed Care Coordinator
  • Family Health Center of M
  • Medford, WI FULL_TIME
  • The Managed Care Coordinator completes insurance requirements and provides case management as needed for services performed in various patient seeing settings. The individual obtains and provides insu...
  • 8 Days Ago

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Managed Care Coordinator
  • Family Health Center of Marshfield, Inc.
  • Neillsville, WI FULL_TIME
  • The Managed Care Coordinator completes insurance requirements and provides case management as needed for services performed in various patient seeing settings. The individual obtains and provides insu...
  • 8 Days Ago

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Managed Care Coordinator
  • Family Health Center of Marshfield, Inc.
  • Medford, WI PART_TIME
  • The Managed Care Coordinator completes insurance requirements and provides case management as needed for services performed in various patient seeing settings. The individual obtains and provides insu...
  • 15 Days Ago

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MANAGED CARE CONTRACT COORD, FCH - MANAGED CARE
  • Froedtert Health
  • Menomonee Falls, WI CONTRACTOR
  • Discover. Achieve. Succeed. #BeHereLocation: US:WI:MENOMONEE FALLS at our WOODLAND PRIME 400 facility. This job is HYBRID.FTE: 1.000000Shift: 1st shift 8 am to 4:30 pm onsite Tuesday and Wednesday the...
  • 5 Days Ago

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Project Coordinator
  • Locknet Managed IT
  • Onalaska, WI FULL_TIME
  • Are you a master of coordination, innovation, and client success? We're seeking a dynamic Project Coordinator to orchestrate seamless communication and drive impactful projects across diverse technolo...
  • 9 Days Ago

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Managed Care Coordinator
  • MJHS
  • New York, NY
  • Req #: 1509 Job ID: 13084 Job Location: New York, NY Zip Code: 10040 Category: Office and Administrative Support Agency:...
  • 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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Managed Care Coordinator - Foster Care
  • Elevance Health
  • Radford, VA
  • Description The Foster Care Managed Case Manager is responsible for overall management of member's individual service pl...
  • 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

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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...
  • 6/6/2024 12:00:00 AM

Wisconsin is bordered by the Montreal River; Lake Superior and Michigan to the north; by Lake Michigan to the east; by Illinois to the south; and by Iowa to the southwest and Minnesota to the northwest. A border dispute with Michigan was settled by two cases, both Wisconsin v. Michigan, in 1934 and 1935. The state's boundaries include the Mississippi River and St. Croix River in the west, and the Menominee River in the northeast. With its location between the Great Lakes and the Mississippi River, Wisconsin is home to a wide variety of geographical features. The state is divided into five dist...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$48,861 to $83,858

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