Managed Care Coordinator jobs in New Jersey

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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Managed Care Liaison
  • Guidance Care HMO
  • Lakewood, NJ FULL_TIME
  • Guidance Care HMO is looking to hire Full Time employees in our Liaison Department.

    Our Liaison Department assists nursing homes with various billing inquiries and other issues related to Managed Care.

    Applicants must have experience in either medical billing or case management (authorization requests, clinical review processes etc.) as it relates to skilled nursing facilities.

    The position requires exceptional organization skills as well the ability to multitask in a fast paced work environment. Proficiency in EMR’s preferred.

  • 1 Month Ago

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Per Diem Field Case Manager
  • First Managed Care Option
  • Parsippany, NJ PER_DIEM
  • First MCO, a NJ licensed managed care organization, offers medical case management services to numerous Auto and Workers’ Compensation carriers. A position is currently available for a Per Diem Field ...
  • Just Posted

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Recruitment & Credentialing Provider Relations Specialist
  • First Managed Care Option
  • Parsippany, NJ FULL_TIME
  • PRIMARY FUNCTIONResponsible for the procedures associated with recruitment of Auto/Pip experienced providers into network, which includes receipt, review, and processing of credentialing application a...
  • 1 Day Ago

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Finance Clerk
  • First Managed Care Option
  • Parsippany, NJ FULL_TIME
  • PRIMARY FUNCTION• Cash application and daily deposit reports• Refund and write off processing• Scanning and filing• Perform other special projects as neededRESPONSIBILITIES• Review incoming mail and c...
  • 1 Month Ago

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Copywriter/Content Marketer
  • First Managed Care Opti
  • Parsippany, NJ FULL_TIME
  • Company Overview First MCO is a full-service managed care organization providing medical cost containment services for workers’ compensation programs and auto insurers. First MCO is a dynamic and inno...
  • 30 Days Ago

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Director of Managed Care
  • Englewood Health
  • Englewood, NJ FULL_TIME
  • Job Summary: Under the general direction and leadership of the Vice President for Finance; plans, organizes and directs the operational functions of the Medical Center as they relate to managed care. ...
  • 8 Days Ago

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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) ...
  • 4/24/2024 12:00:00 AM

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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...
  • 4/24/2024 12:00:00 AM

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RN Utilization Management Managed Care Coordinator
  • Professional Management Enterprises
  • Columbia, SC
  • Job Description Job Description Seeking an RN with Managed Care and Utilization Management experience to review and eval...
  • 4/24/2024 12:00:00 AM

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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...
  • 4/23/2024 12:00:00 AM

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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, ...
  • 4/23/2024 12:00:00 AM

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RN - Registered Nurse Case Manager - Care Coordination
  • Geisinger
  • Wilkes Barre, PA
  • Job Title: RN - Registered Nurse Case Manager - Care Coordination Location: Wilkes-Barre, Pennsylvania Job Category: RN ...
  • 4/22/2024 12:00:00 AM

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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) ...
  • 4/20/2024 12:00:00 AM

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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...
  • 4/20/2024 12:00:00 AM

New Jersey is bordered on the north and northeast by New York (parts of which are across the Hudson River, Upper New York Bay, the Kill Van Kull, Newark Bay, and the Arthur Kill); on the east by the Atlantic Ocean; on the southwest by Delaware across Delaware Bay; and on the west by Pennsylvania across the Delaware River. New Jersey is often broadly divided into three geographic regions: North Jersey, Central Jersey, and South Jersey. Some New Jersey residents do not consider Central Jersey a region in its own right, but others believe it is a separate geographic and cultural area from the Nor...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$53,989 to $92,654

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