Managed Care Coordinator jobs in Nevada

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)

P
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.
  • 7 Days Ago

C
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...
  • 10 Days Ago

M
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...
  • 6 Days Ago

L
Special Care Unit Care Coordinator (Registered Nurse/RN)
  • Life Care Centers of America
  • Las Vegas, NV OTHER
  • Position Summary The RN Special Care Unit Care Coordinator is responsible for supervising, implementing, coordinating, and managing patient care through interpersonal contact with patients, families, ...
  • 22 Days Ago

P
Care Coordinator
  • Proud Moments
  • Las Vegas, NV FULL_TIME
  • Overview To support our rapid growth and commitment to quality care, Proud Moments ABA actively seeks a Care Coordinator to support families and be a liaison between the care team and clients receivin...
  • 3 Days Ago

A
Care Coordinator
  • apree health
  • Carson, NV FULL_TIME
  • Care Coordinator Position Summary: The Care Coordinator is responsible for a wide range of administrative and clinical tasks to assist our clinical care teams in population health management of our pa...
  • 9 Days Ago

B
Managed Care Coordinator - Referrals
  • Beth Israel Lahey Health
  • Boston, MA
  • When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. Job Typ...
  • 3/28/2024 12:00:00 AM

E
Managed Care Coordinator
  • Elevance Health
  • Roanoke, VA
  • Anticipated End Date: 2024-04-22 Position Title: Managed Care Coordinator Job Description: Managed Care Coordinator MUST...
  • 3/27/2024 12:00:00 AM

M
Managed Care Coordinator
  • MJHS Health System
  • New York, NY
  • Req #: 1509 Job ID: 13084 Job Location(s): New York, NY Zip Code: 10040 Category: Office and Administrative Support Agen...
  • 3/26/2024 12:00:00 AM

S
Manager, Care Coordination
  • SCAN
  • Long Beach, CA
  • About SCAN SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adult...
  • 3/26/2024 12:00:00 AM

S
Manager-Care Coordination
  • St. Catherine of Siena
  • Rockville Centre, NY
  • Overview Manager, Care Coordination (RN), Rockville Centre, NY Explore a career with Mercy Hospital, a 375-bed not-for-p...
  • 3/26/2024 12:00:00 AM

C
Manager Care Coordination
  • Crouse Hospital
  • Syracuse, NY
  • Care Coordination is a collaborative practice model including the multidisciplinary health care team, the patient and fa...
  • 3/24/2024 12:00:00 AM

C
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...
  • 3/24/2024 12:00:00 AM

H
Utilization Management Care Coordinator
  • Humana, Inc.
  • Clarksville, IN
  • Completes inbound and outbound provider calls to answer UM related questions and prepare authorization request for clini...
  • 3/24/2024 12:00:00 AM

Nevada is almost entirely within the Basin and Range Province, and is broken up by many north-south mountain ranges. Most of these ranges have endorheic valleys between them, which belies the image portrayed by the term Great Basin. Much of the northern part of the state is within the Great Basin, a mild desert that experiences hot temperatures in the summer and cold temperatures in the winter. Occasionally, moisture from the Arizona Monsoon will cause summer thunderstorms; Pacific storms may blanket the area with snow. The state's highest recorded temperature was 125 °F (52 °C) in Laughlin (e...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$50,149 to $86,065

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