Managed Care Coordinator
Also referred to as: Coordinator of Managed Care, Managed Care Coordinator
Requirements and Responsibilities
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's degree of 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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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
Categories:  Healthcare -- Practitioners, Healthcare -- Administrative, Non-Profit and Social Services
Industries:  Edu., Gov't. & Nonprofit, Healthcare,
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