Skills & Competencies for Managed Care Coordinator

Managed Care Coordinator job profile

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JOB SUMMARY for Managed Care Coordinator

Coordinates utilization reviews of managed care contracts using established guidelines and processes.

JOB RESPONSIBILITIES for Managed Care Coordinator

Ensures all clinical operations comply with Medicare and Medicaid guidelines and other managed care policies. 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.

Managed Care Coordinator SALARY RANGE

BASE 50%
$72,872
TOTAL 50%
$72,872
Job Level
A04
Job Code
HC07000323
Education/Degree
Associate's Degree
Reports To
Supervisor or Manager

Managed Care Coordinator Skills and Competencies List

Proficiency Levels and Behavioural Indicators
Salary.com identifies five increasing levels of proficiency for each skill/competency. Some jobs require only a relatively low level of proficiency in each skill/competency, while other jobs will require a more advanced level of proficiency in the same skill/competency. These levels rate the degree of proficiency (skill level, expertise) we expect the incumbent to perform in the given skill/competency for the given job. Note that we intentionally do not associate timeframes or years of experience in performing the skill/competency because that can be misleading. Proficiency levels identify what the incumbent knows and can do rather than how long they have been doing it. Also, note that the proficiency levels are cumulative, e.g., a level 4 proficiency implies the ability to perform all the behaviors at the lower levels.
Check each Managed Care Coordinator skill and competencie below to view definitions.
JOB FAMILY COMPETENCIES CORE COMPETENCIES
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7 general skills or competencies (Job family competencies) for Managed Care Coordinator

1 Job Family Competencies – Healthcare Industry
Proficiency Level -2
Skill definition-Applying healthcare industry knowledge to manufacture drugs and equipment and offer clinical and other healthcare-related support services.
Level 1 Behaviors
(General Familiarity)
Explains the clinical benefits of integrating innovations and technological advances into healthcare services.
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Level 2 Behaviors
(Light Experience)
Supports the development of innovative healthcare practices to reduce healthcare costs.
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Level 3 Behaviors
(Moderate Experience)
Leverages advanced analytics to improve patient-based service outcomes.
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Level 4 Behaviors
(Extensive Experience)
Integrates advanced processes into clinical workflows to diagnose and treat diseases more precisely.
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Level 5 Behaviors
(Mastery)
Leads the development of services and solutions to address complex healthcare industry challenges.
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2 Job Family Competencies – Healthcare Knowledge
Proficiency Level -2
Skill definition-Utilizing and sharing knowledge of healthcare practices, processes, systems, and procedures to provide high-quality services to patients.
Level 1 Behaviors
(General Familiarity)
Explains the importance of healthcare services in disease prevention and control.
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Level 2 Behaviors
(Light Experience)
Records healthcare information using different mediums for transmission.
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Level 3 Behaviors
(Moderate Experience)
Uses a healthcare system to maintain resources for evidence-based research for the organization.
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Level 4 Behaviors
(Extensive Experience)
Manages the creation, coordination, and execution of valuable healthcare programs within the organization.
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Level 5 Behaviors
(Mastery)
Establishes a "knowledge-sharing" environment to contribute to breakthroughs in the healthcare service industry.
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3 Managed Care Coordinator - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Managed Care Coordinator
Proficiency Level - 4
5 Competency for - Managed Care Coordinator
Proficiency Level - 5

5 soft skills or competencies (core competencies) for Managed Care Coordinator

1 Core Competencies – Attention to Detail
Proficiency Level -3
Skill definition-Executing and completing a task with a high level of accuracy.
Level 1 Behaviors
(General Familiarity)
Lists best practices and tools to maintain high accuracy and thoroughness in the workplace.
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Level 2 Behaviors
(Light Experience)
Records all appointments on the calendar to easily track daily activities.
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Level 3 Behaviors
(Moderate Experience)
Sets up processes to ensure delivery of high-quality work.
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Level 4 Behaviors
(Extensive Experience)
Employs techniques for motivating personnel to meet or exceed accuracy goals.
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Level 5 Behaviors
(Mastery)
Leads the creation of tools for enhancing and assuring accuracy.
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2 Core Competencies – Time Management
Proficiency Level -3
Skill definition-Managing and setting priorities, goals, and timetables to boost productivity and efficiency in completing tasks.
Level 1 Behaviors
(General Familiarity)
Explains the importance of time management in driving the overall productivity of our business.
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Level 2 Behaviors
(Light Experience)
Employs the 80-20 rule to avoid perfectionism and minimize time-wasting.
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Level 3 Behaviors
(Moderate Experience)
Handles workplace obstacles to maintain focus and manage time efficiently.
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Level 4 Behaviors
(Extensive Experience)
Manages teams in streamlining work-related tasks to prioritize highest value tasks firsts.
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Level 5 Behaviors
(Mastery)
Keeps current on the latest working models on time management to drive organizational productivity.
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3 Managed Care Coordinator - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Managed Care Coordinator
Proficiency Level - 4
5 Competency for - Managed Care Coordinator
Proficiency Level - 5

Summary of Managed Care Coordinator skills and competencies

There are 0 hard skills for Managed Care Coordinator.
7 general skills for Managed Care Coordinator, Healthcare Industry, Healthcare Knowledge, Case Management, etc.
5 soft skills for Managed Care Coordinator, Attention to Detail, Time Management, Initiative, etc.
While the list totals 12 distinct skills, it's important to note that not all are required to be mastered to the same degree. Some skills may only need a basic understanding, whereas others demand a higher level of expertise.
For instance, as a Managed Care Coordinator, he or she needs to be skilled in Attention to Detail, be skilled in Time Management, and be skilled in Initiative.

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