Managed Care Coordinator jobs in Las Vegas, NV

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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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Las Vegas, NV 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 medication utilization, formulary management, and ensuring cost-effective pharmacy services. The ideal candidate will bring a deep understanding of managed care principles, a proactive approach to problem-solving, and a commitment to optimizing pharmacy outcomes within a managed care environment.

    Preferred Qualifications:
    PharmD degree from an accredited pharmacy program
    Previous experience in Pharmacy Benefit Management (PBM) or Managed Care
    Knowledge of formulary development and management
    State pharmacy license in good standing
    Strong analytical and data interpretation skills
    Excellent communication and negotiation abilities
    Familiarity with healthcare regulations and compliance standards
    Collaboration experience with healthcare providers, payers, and pharmaceutical manufacturers
    Proficiency in utilizing pharmacy management software and tools
    Active participation in relevant professional organizations
    Dedication to staying informed about industry trends and innovations

    Responsibilities:
    Collaborate with healthcare stakeholders to implement and optimize pharmacy benefit programs
    Conduct formulary reviews and assessments to ensure cost-effective and evidence-based medication choices
    Monitor and analyze pharmacy utilization trends, identifying opportunities for cost savings and improved patient outcomes
    Provide expertise in drug utilization management and prior authorization processes
    Stay informed about industry regulations, guidelines, and emerging trends in managed care pharmacy
    If you are a passionate and experienced pharmacist with a background in PBM or Managed Care, we invite you to join our dynamic team dedicated to advancing healthcare through innovative and cost-effective pharmacy solutions. Apply now to contribute to the future of managed care pharmacy.
  • 1 Month Ago

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Director of Managed Care Vendor Administration
  • Eastridge
  • Las Vegas, NV FULL_TIME
  • Eastridge Workforce Solutions is a leading provider of workforce management solutions, dedicated to connecting skilled professionals with rewarding opportunities. In partnership with a well-establishe...
  • 9 Days Ago

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Director of Managed Care Vendor Administration
  • Eastridge
  • Las Vegas, NV FULL_TIME
  • Eastridge Workforce Solutions is a leading provider of workforce management solutions, dedicated to connecting skilled professionals with rewarding opportunities. In partnership with a well-establishe...
  • 9 Days Ago

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Assistant Director of Contracting and Managed Care
  • Clinical Management Consultants
  • Springs, NV FULL_TIME
  • A fantastic career opportunity for Assistant Director of Managed Care and Contracting is now available with a prestigious healthcare system in Nevada! The Assistant Director of Contracting and Managed...
  • 13 Days Ago

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Mobile Diesel Technician - Advanced
  • Managed Mobile
  • Las Vegas, NV FULL_TIME
  • Managed Mobile is looking for an advanced level Journeyman Technician with a wide breadth of experience who can diagnose and repair medium/heavy duty trucks. The selected candidate will work independe...
  • 1 Month Ago

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Care Coordinator
  • Possibilities
  • Saint George, UT FULL_TIME
  • Care Coordinator Purpose & Mission The Care Coordinator is the family’s point of contact and designated advocate throughout the intake and service delivery process. While some staff turnover may be un...
  • 4 Days Ago

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0 Managed Care Coordinator jobs found in Las Vegas, NV area

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Dental Patient Care Coordinator
  • ELLSWORTH DENTAL CARE LLC
  • Las Vegas, NV
  • Job Description Job Description Dental Patient Care Coordinator Established patient health-centered dental practice loca...
  • 4/25/2024 12:00:00 AM

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Addiction Counselor-LI (Remote Opportunity)Telehealth Behavioral Health
  • Nyc Health + Hospitals
  • Las Vegas, NV
  • About NYC Health + Hospitals: Lincoln Medical and Mental Health Center is one of New York Citys premier acute care hospi...
  • 4/25/2024 12:00:00 AM

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Lab Point of Care Coordinator-Medical Technologist
  • MountainView Hospital
  • Las Vegas, NV
  • Description Hourly Wage Estimate: $34.64 - $51.95 / hour Learn more about the benefits offered for this job. The estimat...
  • 4/24/2024 12:00:00 AM

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Addiction Counselor-LI (Remote Opportunity)Telehealth Behavioral Health
  • NYC Health + Hospitals
  • Las Vegas, NV
  • About NYC Health + Hospitals: Lincoln Medical and Mental Health Center is one of New York City’s premier acute care hosp...
  • 4/24/2024 12:00:00 AM

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Patient Care Coordinator
  • Desert Orthopaedic Center
  • Las Vegas, NV
  • Job Description Job Description You will be an integral part of DOC and the community we serve by answering phones, answ...
  • 4/24/2024 12:00:00 AM

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Occupational Therapist (OT) for Home Health
  • FeldCare Connects
  • Las Vegas, NV
  • This position is for an Independent Contractor to serve the Las Vegas area. FeldCare Connects is currently seeking a sel...
  • 4/24/2024 12:00:00 AM

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Hospice Transitional Care Coordinator
  • Dynamic Nursing, Inc.
  • Las Vegas, NV
  • Job Description Job Description JOB DESCRIPTION / RESPONSIBILITES Dynamic is a family owned, Home Health and Hospice Age...
  • 4/23/2024 12:00:00 AM

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Registered Nurse RN Home Health
  • Care Network Home Health
  • Las Vegas, NV
  • Job Description Job Description Job Title: Registered Nurse (RN) - Home Health Location: Las Vegas area Pay Rate: $150 t...
  • 4/23/2024 12:00:00 AM

Las Vegas is situated within Clark County in a basin on the floor of the Mojave Desert and is surrounded by mountain ranges on all sides. Much of the landscape is rocky and arid with desert vegetation and wildlife. It can be subjected to torrential flash floods, although much has been done to mitigate the effects of flash floods through improved drainage systems. The peaks surrounding Las Vegas reach elevations of over 10,000 feet (3,000 m), and act as barriers to the strong flow of moisture from the surrounding area. The elevation is approximately 2,030 ft (620 m) above sea level. According t...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$49,753 to $85,383
Las Vegas, Nevada area prices
were up 2.5% from a year ago

Managed Care Coordinator in San Francisco, CA
Care managers also sometimes provide case management--for example, information about transportation assistance, food programs, and other social services.
December 12, 2019
Managed Care Coordinator in Santa Barbara, CA
Nursing home administrators manage staff, admissions, finances, and care of the building, as well as care of the residents in nursing homes.
February 02, 2020
Managed Care Coordinator in Orange, CA
Assist with on-boarding and training of new Managed Care Coordinators.
January 20, 2020