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)
Apple Rehab is a family owned and operated company that treats residents and staff like family too. Our expert team of senior management is located at our home office, right in Avon, CT, ensuring superior care from a local company. Our leadership is not across the country, but rather in your backyard.
Job Description
$85,000-$95,000/ per year
The Corporate Medicare/Managed Care Manager is responsible for ensuring the maximization of cash flow and reduced bad debt by managing resolution of problem accounts referred by the facility AR staff, Administrator and Regional A/R Managers. Also responsible for maintaining Medicare and Managed Care Program/Contracting requirements including revalidations, re-credentialing and User Access.
Qualifications
Administrative Functions: