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)
AgeSpan
Formerly Elder Services of the Merrimack Valley/North Shore
At AgeSpan, you'll find a work environment that combines:
Depending on your role and your hours, we offer:
Position Responsibilities:
Assist Managed Care Staff with administrative and consumer related functions to support the work of the Managed Care staff, including home visits to applicants/consumers as required. Position includes home visits in the 28 cities and towns in the Merrimack Valley and North Shore.
Essential Functions: (Core duties or tasks that are fundamental and not marginal to the performance of the job)
Qualifications:
Associates Degree preferred. High School diploma and a minimum of one year of related work experience required. Experience in Human Service environment helpful. Computer skills required. Must be responsible and have compassion for older adults and people with disabilities. Excellent interpersonal and communication skills a must in this team oriented position. Must have valid Driver's License and reliable transportation. A bilingual capacity in either Khmer or Spanish is strongly preferred.
Hours per week : 37.5 hours per week
AA/EOE
AgeSpan is strongly committed to fostering a professional environment that recognizes, respects, and encourages the unique contributions of a broad spectrum of qualified employees. It is important that our employees reflect the diverse communities we serve. We maintain a work atmosphere that allows people of varied backgrounds to grow professionally and contribute to our mission by promoting diversity, equity, inclusion, and work-life balance.
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