Managed Care Coordinator Overview • The Managed Care Coordinator ensures members receive timely, appropriate services by processing authorizations and coordinating with providers and vendors. • This role involves tracking hospital admissions and discharges while maintaining accurate member records and routing cases to clinical staff when necessary. • Supports high-quality, cost-effective care for Medicare and Medicaid members through effective care coordination and healthcare operations. • Provides coverage for employees on leave, ensuring continuity in managed care operations and member services. • Hybrid work arrangement with two days per week in the office, offering flexibility and collaboration opportunities. • Temporary six-month contract position with potential for impactful contributions to healthcare service delivery. • Ideal for candidates with previous healthcare experience, particularly in care coordination or management roles. • Opportunity to work with interdisciplinary teams to enhance member care and operational efficiency. Managed Care Coordinator Key Responsibilities & Duties • Process initial requests and inquiries for preauthorization of services and supplies, ensuring compliance with regulatory guidelines. • Coordinate communication and authorization with vendors, processing requests within established timeframes. • Perform accurate and timely data entry tasks to support departmental workflows and maintain high data integrity. • Receive and coordinate notifications of inpatient admissions and discharges, routing information to appropriate case managers. • Research, update, and maintain team files to ensure accurate tracking of member eligibility and case assignments. • Collaborate with interdisciplinary teams to resolve member issues and provide seamless care coordination. • Ensure compliance with departmental standards and regulatory requirements in all aspects of managed care operations. • Support care management activities by routing cases requiring clinical review to appropriate staff. Managed Care Coordinator Job Requirements • High School Diploma or equivalent required; college degree preferred for enhanced qualifications. • Minimum of one year of managed care experience, preferably in a healthcare setting. • Familiarity with medical terminology, utilization management, or case management is highly desirable. • Strong written and oral communication skills to effectively interact with members and interdisciplinary teams. • Analytical abilities to assess member needs and recommend alternative levels of care. • Empathy and understanding to handle confidential aspects of member care coordination. • Ability to work independently while recognizing issues impacting departmental or organizational goals. • Proficiency in maintaining collegial relationships and collaborating within interdisciplinary team environments.