Managed Care Coordinator jobs in Utah

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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Case Manager - Managed Care
  • Weber Human Services
  • Ogden, UT FULL_TIME
  • Job Description:


    Help coordinate mental health, medical, substance abuse services and social service needs of the adult mental health clients.

    Ensure clients have needed resources by linking, assisting and coordinating.

    Meet with each client individually and set meetings between them and all of the care team members.

    Document services in each clients’ chart.

    Respond to alerts received about each client.

    Check to ensure each client has necessary medication.

    Coordinate with the clients’ treatment team, the inpatient hospital and residential staff regarding client needs.


    Experience and Skills:

    Would prefer a Bachelor's Degree but would interview a Graduate from high school or GED

    AND twelve (12) months of supervised practice/experience in completion of a practicum working with mentally ill adults or some other social service program OR Equivalent combination of education and related experience.


    Job Benefits:

    Weber Human Services

    Benefit Package Overview

    July 1, 2023 – June 30, 2024

    • Your Benefit Package can include 40-100% of wage depending on what options are chosen.

    Eligibility:

    You are eligible to enroll for benefits if you are a full-time employee working 30 or more hours per week. (Rates are on a sliding scale for employees that work under 40 hours a week).

    HEALTH INSURANCE

    PEHP (Effective on the first day following the month that the employee is hired)

    Coverage is offered to the employee, spouse and children under age 26. Advantage Star includes IHC Network; Summit Star includes Ogden Regional Network. (Rates are deducted twice monthly through payroll deduction.)

    High Deductible STAR 1HSA Contribution

    Single Coverage: $56.20 (WHS pays $637.18 monthly toward your premium)

    2 Party Coverage: $154.42 (WHS pays $1235.38 monthly toward your premium)

    Family Coverage: $230.88 (WHS pays $1637.18monthly toward your premium

    Single Coverage: $32.67 contributed to your account twice a month

    2 Party Coverage: $74.25 contributed to your account twice a month

    Family Coverage: $89.29 contributed to your account twice a month


    Below represents using an in-network provider:

    Preventive Services are covered at 100%

    Fiscal year deductibles: $1,500 Single; $3,000 2 Party; $3,000 Family

    Employee pays all deductibles. Once the deductible is satisfied, employee pays 20% up to $3000 for single, and $6000 for double or family.

    High Deductible STAR 2HSA Contribution

    Single Coverage: $49.37 (WHS pays $559.54 monthly toward your premium)

    2 Party Coverage: $135.61 (WHS pays $1084.84 monthly toward your premium)

    Family Coverage: $202.75 (WHS pays $1437.70 monthly toward your premium

    Single Coverage: $68.58 contributed to your account twice a month

    2 Party Coverage: $138.88 contributed to your account twice a month

    Family Coverage: $174.96 contributed to your account twice a month


    Below represents using an in-network provider:

    Preventive Services are covered at 100%

    Fiscal year deductibles: $3,000 Single; $6,000 2 Party; $6/000 Family

    Employee pays all deductibles. Once the deductible is satisfied, employee pays 20% up to $6000 for single, and $12,000 for double or family.

    Traditional Plan - Advantage Star includes IHC Network; Summit Star includes Ogden Regional Network. (Rates are deducted twice monthly through payroll deduction.)

    Single Coverage $77.93 (WHS pays $623.40 monthly toward your premium)

    2 Party Coverage $184.61 (WHS pays $1236.06 monthly toward your premium)

    Family Coverage $272.74 (WHS pays $1636.06monthly toward your premium)

    Below represents using an in-network provider:

    Preventive Services are covered at 100%

    Fiscal year deductibles: $1500 Single; $3,000 Double; $3,000 Family

    Primary Care Provider - $30 (deductible waived)

    Specialist Provider - $40 (deductible waived)

    Urgent Care - $50 (deductible waived)

    Emergency Room - $500

    Impatient Services: Medical, Surgical, Hospice and Emergency Admissions – 30% after deductible

    Prescriptions: 20% for Tier A; 30% for Tier B

    Autism Spectrum Disorder Benefit

    Covers children ages 2-9 years of age, up to 600 hours per year of behavioral health treatment. Requires mental health services preauthorization through PEHP.

    Ability to Waive Coverage upon proof of other medical coverage

    Employees hired to work 40 hours per week may waive medical coverage and in lieu choose:

    $287.72 deposited per biweekly pay period into their 401(k) or 457 plan;

    OR

    $143.86 paid per biweekly pay period as taxable income. The amounts paid are on a sliding scale for those working less than 40 hours per week. (Proof of other medical insurance coverage must be provided to choose these options.)

    NICE HEALTHCARE

    NICE is an integrated primary care clinic that brings FREE medical visits, medications, labs, imaging, physical therapy and mental health therapy to you. Nice’s in-home and virtual visits come with no out-of-pocket costs, as so all services included in your treatment plan.

    • Features same day chat and video visits
    • Primary care for wellness, acute and chronic conditions
    • In-home visits with 35 FREE labs and Physical Tests
    • 550 Free Medications can be prescribed by physicians
    • Virtual Physical Therapy visits
    • Virtual Mental Health Therapy visits
    • In-home X-rays an EKG services

    DENTAL INSURANCE

    Dental Select (Effective on the first day following the month that the employee is hired)

    Coverage is offered to the employee, spouse and children under age of 26.

    Employee may waive medical coverage and carry dental coverage only. No compensation shall be made for waiving dental coverage. Rates are semi-monthly through payroll deduction:

    Single Coverage: $5.24

    2 Party Coverage: $7.17

    Family Coverage: $10.86

    Below represents using an in-network provider:

    Preventive: Cleanings, routine exams, x-rays, topical fluoride (2 per fiscal year) – 100%

    Basic; Fillings, extractions, oral surgery, endodontics – 80%

    Major: Crowns, bridges, dentures and periodontics – 50%

    Orthodontics – Children and Adults – 50% of eligible fees to plan maximum ($1,500 maximum lifetime benefit per member

    Deductible – Applies to basic and major services – $25 per individual and $75 family maximum

    VISION INSURANCE

    EyeMed (Effective on the first day following the month that the employee is hired)

    Rates are semi-monthly through payroll deduction

    Single Coverage: $2.68

    2 Party Coverage $5.25

    Family Coverage: $6.95

    Below represents using an in-network provider:

    No examination benefit

    Lenses – Standard plastic; $10 co-pay

    Frames – Allowance based on retail pricing - $120 allowance

    Contacts – Benefits is in lieu of lens and frame benefit - $120 allowance (additional contact purchases are at retail prices)

    Frequency – Every 12 months

    LASIK – 15% off retail price or 5% of promotional price

    LIFE INSURANCE

    Basic Life Insurance – Hartford: (Effective on the first day following the month that the employee is hired)

    Weber Human Services provides $25,000 basic life insurance through Hartford Life Insurance at no cost to the employee.

    Supplemental Term Life Insurance - Hartford: (Effective upon approval from Hartford Life Insurance)

    An employee may purchase supplemental term life insurance for themselves, their spouse and children at various costs based on age and the amount of insurance desired through payroll deduction.

    SHORT TERM DISABILITY

    Optional plan for employees. Premium is based on pay, and can help protect your paycheck up to 60% for back injury, pregnancy, or serious illness that can lead to months without a regular paycheck.

    SUPPLEMENTAL ALLSTATE

    Allstate Supplemental Insurance: (Effective upon approval from Allstate)

    A supplemental insurance plan offered through payroll deduction. Plans offered are Critical Illness and Accident.

    FLEX SPENDING ACCOUNT

    Cafeteria Plan – National Benefits Services Reimbursement Account: (Effective on the first day following the month that the employee is hired)

    The health care reimbursement allows the employee to set aside up to $3,050 in pretax dollars to pay eligible out of pocket medical, dental, vision, prescriptions and non-prescription expenses through payroll deduction.

    The dependent care reimbursement allows you to set aside up to $5,000 in pretax dollars to pay for eligible dependent care expenses through payroll deduction.

    EMPLOYEE ASSISTANCE PROGRAM

    Guidance Resources Program – SUPPORTLINC

    Guidance Resources is a no-cost, company sponsored benefit that is available to you and your dependents to provide confidential support, resources and information to get through life’s challenges. Confidential counseling on personal issues; legal information; resources and consultation; financial information; resources and tools; online information, tools and services.

    PAID LEAVE

    Paid Leave – Holiday, Sick, Vacation: (Effective the first pay period after hire date)

    Holidays – 12 per calendar year

    Sick – 4 hours earned per biweekly pay period. 104 hours per calendar year

    Vacation:

    0 through 5 years: 4 hours earned per biweekly pay period = 104 hours per calendar year.

    6 years through 10 years: 5 hours earned per biweekly pay period = 130 hours per calendar year.

    11 years through 15 years: 6 hours earned per biweekly pay period = 156 hours per calendar year.

    16 years plus: 6.5 hours earned per biweekly pay period = 169 hours per calendar year.

    UTAH RETIREMENT

    Utah Retirement Systems: (Effective on date of hire)

    Tier 1 – Employees hired before July 1, 2011, or newly hired employees who are transferring from another agency under Utah Retirement Systems. You must be employed at least 4 years with Weber Human Services, or a combination of Weber Human Services and another state agency, in order to be vested to receive your pension plan at retirement age. Weber Human Services contributes 18.47% per biweekly pay period towards URS pension plan.

    Tier 2 – Employees hired after July 1, 2011. Weber Human Services contributes an amount equal to 10% of your salary between both plans: pension and 401(k). Pension contributions are based on the yearly pension contribution rate. Pension and employer contributions to your 401(k) are vested after four years.

    The following applies to both Tier 1 and Tier 2 retirement systems:

    An employee may also contribute through payroll deduction to a 401(k), 457, Roth or Traditional IRA.

    Weber Human Services will also match up to 1% of employee contribution towards 401(k)

    Upon termination, all money vested into your 401(k) becomes property of the employee.

    From: Weber Human Services

  • 18 Days Ago

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Director of Managed care/ insurance or healthcare
  • Top Tier Consulting LLC
  • Sandy, UT FULL_TIME
  • Responsibilities:-Director, Managed Care Sandy, UT, United States Full Time 10 paid holidays, 6% 401 k match, PTO, tuition reimbursement, and more Position The Claims Services department has an immedi...
  • 22 Days Ago

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Patient Care Coordinator
  • Abundant Dental Care
  • Sandy, UT FULL_TIME
  • Abundant Dental Care, a dentist-owned and dentist-led dental corporation with many offices along the Wasatch Front and focused on elevating dental professionals to mastery, is hiring a Patient Care Co...
  • 5 Days Ago

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Patient Care Coordinator
  • Abundant Dental Care
  • Holladay, UT FULL_TIME
  • Abundant Dental Care, a dentist-owned and dentist-led dental corporation with many offices along the Wasatch Front and focused on elevating dental professionals to mastery, is hiring a Patient Care Co...
  • 5 Days Ago

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Care Coordinator
  • The Family Place
  • Smithfield, UT PART_TIME
  • The Family Place Utah is seeking a part-time (20 hours per week) Care Coordinator to join our Trauma Resiliency Project (TRP) in support of our mission, “Strengthening families and protecting children...
  • 22 Days Ago

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Airport Rental Car Cleaner ($15.00 per hour • Daily Pay Access)
  • Managed Labor Solutions
  • Salt Lake, UT FULL_TIME
  • Do you enjoy late model cars, have a good attention to detail, and need a flexible schedule plus access to daily pay? Managed Labor Solutions (MLS), a leading nationwide rental car outsourcing company...
  • Just Posted

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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) ...
  • 4/15/2024 12:00:00 AM

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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...
  • 4/15/2024 12:00:00 AM

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RN - Registered Nurse Case Manager - Care Coordination
  • Geisinger
  • Zion Grove, PA
  • Job Title: RN - Registered Nurse Case Manager - Care Coordination Location: Danville, Pennsylvania Job Category: RN - Re...
  • 4/15/2024 12:00:00 AM

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RN - Registered Nurse Case Manager - Care Coordination
  • Geisinger
  • Nuremberg, PA
  • Job Title: RN - Registered Nurse Case Manager - Care Coordination Location: Danville, Pennsylvania Job Category: RN - Re...
  • 4/15/2024 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) ...
  • 4/14/2024 12:00:00 AM

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Case Manager/Care Coordination Consultant
  • Boys Town
  • West Palm Beach, FL
  • Provides intensive and professional case management services to youth utilizing a strength based and comprehensive model...
  • 4/14/2024 12:00:00 AM

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Managed Care Coordinator - Referral Specialist
  • TalentBurst, Inc.
  • Boston, MA
  • Specialty: Referral Specialist Duration: 13 Weeks Shift Group: 8H Day REQUISITION COMMENTS AND NOTES •Work collaborative...
  • 4/14/2024 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, ...
  • 4/13/2024 12:00:00 AM

Utah is known for its natural diversity and is home to features ranging from arid deserts with sand dunes to thriving pine forests in mountain valleys. It is a rugged and geographically diverse state that is at the convergence of three distinct geological regions: the Rocky Mountains, the Great Basin, and the Colorado Plateau. Utah is one of the Four Corners states, and is bordered by Idaho in the north, Wyoming in the north and east; by Colorado in the east; at a single point by New Mexico to the southeast; by Arizona in the south; and by Nevada in the west. It covers an area of 84,899 sq mi ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Coordinator jobs
$46,847 to $80,396

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