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)
The responsibilities for this position include:
* presenting Griswold as "the best provider of home care."
*answering the phone and speaking with people
*scheduling and coordinating care for our clients as well as providing support for our caregivers
*communicating between clients, families and staff
*recruiting and orienting staff
*helping in developing client care plans
*maintaining client confidentiality and quality care
*listening to client and staff concerns
*be part of the rotation for on-call
*assist in developing leads,introduce potential leads while promoting the agency through communicating the value of our services and always presenting a positive image in the community
*always be an information resource for clients, caregivers and referral sources
Qualifications:
*exhibit strong communication skills and be able to communicate clearly and concisely in both verbal and written form, fluent in English
*be able to work with individuals of varying backgrounds toward a common goal for the betterment for the client
*high school or advanced education is encouraged
*there will be on the job training
*comfortable with working and inputting into computer
*preferred individual who has understanding of general care techniques and the home care industry in general
*strong organizational skills
*good time management
*detail oriented
*valid drive's license, reliable transportation and auto insurance
Griswold Home Care is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy or any other protected characteristic as outlined by federal, state or local laws.
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