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)
Come find out why D&C is Maine’s largest, in-home elder care company! With the highest pay-rates amongst local care agencies, a stellar benefits package, ongoing, a convenient weekly pay schedule and generous paid time off, we strive to be one of the best places to work in Maine, and we welcome you to be part of our growing team!
Don’t just make a living – make a difference - with D&C Home Care Company!
NOW OFFERING:
The Service Coordinator is responsible for coordination of services, and communicating service delivery information to clients and employees in a timely, professional and courteous manner.
Primary Duties and Responsibilities:
A criminal background will be performed on all employees. Employment is contingent upon a clean criminal background.
Scope of Position: Reports to Office Manager.
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