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)
Recently Added Managed Care Coordinator jobs
Care Coordinator - Managed Care Coordination
- ACCESS Community Health Network
-
Chicago, IL
FULL_TIME
- Position Summary The Care Coordinator is a Licensed Social Worker or Counselor who provides care coordination, social support services and outreach services to assist patients in navigating health care transitions, and support patient empowerment through health education, advocacy and coaching. The Care Coordinator ensures the continuity and quality of care for patients and provides care coordination with a Triple Aim approach in mind: Improve the patient experience, improve population health and lower the cost of health care. Core Job Responsibilities •Serve as team lead for intake process, development and maintenance of care plan and promoting health programs and services.•Utilize information systems and decision support, manages a patient panel to proactively contact, educate, and track patients by disease, risk, and self-management status, as well as family and community need.•Lead Patient-Centered Care Planning including assessment, plan, implementation/intervention and evaluation, as well as a method for monitoring and intervening.•Conduct home/community visits (face-to-face) according to policy and workflows.•Provide resources to support patient/families in self-management to meet health care treatment goals, assess readiness to learn and validate learning outcomes.•Purposefully engage patients and/or families to voice care-related questions and concerns and recognizes individual expertise of the patient by coaching and counseling.•Facilitate pre-planning, patient education and empowerment, and assessment of patient barriers to support the most effective and efficient interactions between patients and providers.•Work collaboratively with interdisciplinary teams and health care team members both internal and external to the organization to improve patient care through effective utilization and monitoring of health care resources.•Assist patient and providers from across the care continuum in the transition from outpatient- to inpatient setting, and ensure post-emergency department, hospitalization, and/or specialist follow up.•Appropriately and in a timely manner, document interactions, findings, and continuum of care-related activities in the electronic medical record to assure optimal patient care reporting on quality improvement efforts.•Participate in evaluating outcomes at the individual level with each patient/client and at the same time participate in agency-wide evaluative efforts to ensure and improve the overall quality of service being delivered.•Work collaboratively with the quality department to improve patient outcomes through the review of patient care gaps, educating patients on the importance of prevention care and ongoing needed assessments, remain aware of quality initiatives and ACCESS quality priorities.•Perform other duties as assigned. Requirements/Preferences •Bachelor’s degree required, Master’s degree preferred•Current, unrestricted Illinois license: LCPC, LPC, LCSW or LSW required•Minimum two (2) years’ experience in a clinical setting required.•Care Coordination experience preferred.•Bilingual Spanish a plus.•Previous experience using an electronic medical record preferred.•Intermediate proficiency in Microsoft Office products (Word, Excel, PowerPoint) required. Competencies/Behaviors •Excellent customer service and interpersonal skills; interact with patients with the desire to respond to and meet their needs, requirements, and expectations.•Excellent written and verbal communication skills. Confidence to communicate and outreach to other community health care organizations and personnel.•Collaborative - establish and maintain a collaborative working environment; focused on customer/end user relationships.•Proven decision-making and problem-solving abilities.•Reporting - translate data into meaningful information in report and/or presentation formats.•Analysis - easily consume, process, and analyze data; make recommendations as to appropriate data strategies and tactics.•Organizational skills; strong attention to detail and accuracy•Multitask and meet deadlines, expert attention to detail.•Maintain the confidentiality of records, documents or discussions related to ACCESS functions.•Strategic Thinking - think strategically level of detail analysis to plan and execute.•Emotional Intelligence - exhibits confidence, empathy and respect when communicating with customers (patients), leadership and staff.•Cultural competency - experience working in a multi-cultural environment; work with diverse persons, and personalities.•Coach and train using written, verbal, and visual methods. Working Conditions/Equipment •Normal office environment•Health Center environment•Remote working options; must have a suitable and secure remote working environment.•Local travel between health centers, hospitals and home/community visits is required; mode of transportation, current driver’s license and proof of insurance is required.•Ability to sit at a desk for up to 4 hours at a time•Ability to stand for up to 2 hours at a time•Computer/Laptop•Phone/Fax/Copier/Scanner EMPLOYEE EXPECTATIONS Following are guidelines of expectations for all employees of this organization. These guidelines are incorporated as part of your job description. ➢ Maintain current knowledge in your area of skill and expertise and strive to improve your own work. As an employee you are expected to do the following: ➢ Report to work on time as scheduled. You should be at your work assignment ready to begin work at scheduled starting times. Observe break times appropriately. ➢ Be courteous, friendly, helpful, and supportive. Use a person’s name and use such phrases as “please,” “thank you,” and “may I help you?” whenever appropriate. ➢ Make efficient use of your time at work. Establish priorities with your supervisor and use your time wisely. ➢ Promote team spirit. Work together and cooperate in an effort to promote quality client services and enhance staff relationships. Help fellow staff members perform their work. Share responsibilities. Recognize others’ achievements ➢ Communicate effectively. Be open, honest, and truthful with yourself and others. Talk to your supervisor. Ask questions. Give your supervisor pertinent information, stating the facts without concealing or exaggerating. ➢ Anticipate and meet client needs. Be observant of and react to individual client needs. Client dignity is of primary importance. ➢ Maintain an appropriate appearance. Make sure clothing is clean and you are neatly groomed. It is important to portray a positive image. ➢ Participate in making quality of work better. Suggest improvements to your supervisor. Help others learn correct procedures. Be open to new ideas and methods. ➢ Know the structure, philosophy, and purpose of the organization. Know how you fit into the structure and purpose of the organization. Maintain and promote the philosophy of the organization.
- 1 Month Ago
Managed Care Manager
- Aperion Care
-
Lincolnwood, IL
FULL_TIME
- Description: In support of Managed Care Case Management perform the duties of facilitating daily referral request for all Commercial, MMAI and Medicare Advantage plans for skilled care stays for all A...
- 1 Month Ago
Certified Medical Assistant (CMA)
- Managed Care Staffers
-
Chicago, IL
PART_TIME
- Temp to Hire P/T CMA for large Nephrology Practice. Two locations Advocate Trinity & Munster, IN Office $27/hr Part-time CMA Position (3 days/wk.)24 hours/wk. (Tues, Wed, & one other day which varies ...
- 11 Days Ago
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...
- 16 Days Ago
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...
- 30 Days Ago
Reimbursement Analyst, Managed Care
- Mercy Health Corporation
-
Rockford, IL
FULL_TIME
- OverviewReimbursement Analyst, Managed Care, Days, 80 Hrs / 2 wksLocation: Janesville, WI, OR Rockford, IL OR hybrid remoteSchedule: Monday - Friday; flexible work schedule available after training pe...
- 1 Month Ago
Managed Care Coordinator jobs at Popular Companies
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) ...
- 4/19/2024 12:00:00 AM
Managed Care Coordinator - Referrals
- Beth Israel Lahey Health
-
Plymouth, MA
- **When you join the growing BILH team, you're not just taking a job, youre making a difference in peoples lives.** **Job...
- 4/19/2024 12:00:00 AM
Case Manager/Care Coordination Consultant
- Boys Town
-
West Palm Beach, FL
- Provides intensive and professional case management services to youth utilizing a strength based and comprehensive model...
- 4/19/2024 12:00:00 AM
Manager Care Coordination
- hireneXus Research
-
San Francisco, CA
- Manager Care Coordination Population Health San Francisco Bay Area Here are some of the benefits our client offers! HUGE...
- 4/18/2024 12:00:00 AM
Manager Care Coordination
- Crouse Hospital
-
Syracuse, NY
- Care Coordination is a collaborative practice model including the multidisciplinary health care team, the patient and fa...
- 4/18/2024 12:00:00 AM
Manager Care Coordination
- Catholic Health Services
-
West Islip, NY
- Overview Manager of Care Coordination (MCC) - Registered Nurse (RN) Are you exceedingly driven, dedicated, and passionat...
- 4/18/2024 12:00:00 AM
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, ...
- 4/18/2024 12:00:00 AM
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) ...
- 4/15/2024 12:00:00 AM
About Illinois
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
$50,393 to $86,482
Most Popular Cities in Illinois for Managed Care Coordinator Jobs
What does a Managed Care Coordinator do?
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