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%
$72,728
TOTAL 50%
$72,728
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)
Names the healthcare industry sectors and defines the purpose and functions of each.
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Level 2 Behaviors
(Light Experience)
Uses and maintains electronic health records (EHRs) according to legal and industry standards.
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Level 3 Behaviors
(Moderate Experience)
Works with various industry professionals to formulate new treatment processes for patients.
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Level 4 Behaviors
(Extensive Experience)
Recommends innovations to minimize and control costs in providing quality care to clients.
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Level 5 Behaviors
(Mastery)
Stays abreast of the changes in industry laws to ensure our organization's adherence.
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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)
Identifies different types of healthcare knowledge and describes the significance of each.
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Level 2 Behaviors
(Light Experience)
Supports healthcare audits to gather sources for the creation of knowledge management strategies.
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Level 3 Behaviors
(Moderate Experience)
Works with various medical professionals in processing healthcare data to meet patient needs.
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Level 4 Behaviors
(Extensive Experience)
Promotes the use of knowledge management systems to improve efficiencies across healthcare service operations.
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Level 5 Behaviors
(Mastery)
Leads the development of service quality improvement plans to maximize patient satisfaction and retention.
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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 the traits of an employee showing great attention to detail.
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Level 2 Behaviors
(Light Experience)
Utilizes specific approaches and tools for checking and cross-checking outputs.
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Level 3 Behaviors
(Moderate Experience)
Uses tools to organize and monitor work progress.
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Level 4 Behaviors
(Extensive Experience)
Manages training to improve staffs' concentration and attention to detail.
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Level 5 Behaviors
(Mastery)
Learns from previous works' strengths and weaknesses to guide new projects.
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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)
Lists basic planning tools and applications used in tracking and organizing time and tasks visually.
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Level 2 Behaviors
(Light Experience)
Seeks all resources needed to accomplish a task efficiently and effectively.
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Level 3 Behaviors
(Moderate Experience)
Works closely with colleagues to identify and reduce interruptions and barriers to time utilization.
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Level 4 Behaviors
(Extensive Experience)
Provides strategic direction to the workforce in managing time to avoid low-value work.
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Level 5 Behaviors
(Mastery)
Monitors the performance of business units to determine and eliminate deviations from priorities.
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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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