| Managed Care Coordinator Job Description |
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| The following is a full job description for Managed Care Coordinator. Here are the requirements and responsibilities for Managed Care Coordinator along with statistics. If after reading this page you determine that Managed Care Coordinator is not the position you are looking for, you may want to try one of these similar titles: Managed Care Supervisor, Managed Care Finance Director, Top Managed Care Executive, Managed Care Marketing Manager, Home Care Aide Coordinator, Nursing Education Coordinator - Home Care, Managed Care Pharmacy Manager, Managed Care Pharmacy Supervisor, Vendor Managed Inventory Analyst I |
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| Requirements and Responsibilities For 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. 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. Typically requires an associate degree in nursing. Typically reports to a supervisor or manager. Typically requires Registered Nurse (RN). 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. Typically requires 5-7 years of related experience. |
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| Also referred to as: Care and Utilization Review Nurse Coordinator |
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| Similar Jobs: Managed Care Supervisor, Managed Care Finance Director, Top Managed Care Executive, Managed Care Marketing Manager, Home Care Aide Coordinator, Nursing Education Coordinator - Home Care, Managed Care Pharmacy Manager, Managed Care Pharmacy Supervisor, Vendor Managed Inventory Analyst I |
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| Level of Education: Managed Care Coordinator Salaries with a High School Diploma or Technical Certificate, Managed Care Coordinator Salaries with an Associate's Degree, Managed Care Coordinator Salaries with a Bachelor's Degree, Managed Care Coordinator Salaries with a Master's Degree or MBA, Managed Care Coordinator Salaries with a JD, MD, PhD or Equivalent |
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| Industries: Edu., Gov't. & Nonprofit, Healthcare | |
