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)
At UnitedHealthcare,we’resimplifying the health care experience, creating healthiercommunitiesand removing barriers to quality care.
The work you do hereimpactsthe lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive,affordableandequitable.
Ready to make a difference? Join us to start Caring. Connecting. Growing together.
As part of a care management team who will manage complex members, the Care Coordinator will be the primary care manager for a panel of older adult members with a variety of medical and / or behavioral health needs.
Care coordination activities will focus on supporting member’s medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care.
If you reside in Indiana, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities :
or community-based provider referrals such as PCP, specialists, medication assisted therapy referrals, etc.)
You’llbe rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well asprovidedevelopment for other roles you may be interested in.
Required Qualifications :
food banks, non-emergent transportation, utility assistance, housing / rapid re-housing assistance, etc.)
Preferred Qualifications :
Physical Requirements :
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone.
We believe everyone of every race, gender, sexuality, age, location and income deserves the opportunity to live their healthiest life.
Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes.
We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere : UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Last updated : 2024-11-22
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