Managed Care Coordinator I
4 weeks ago
- Utilizes clinical proficiency and claims knowledge/analysis to assess, plan, implement, health coach, coordinate, monitor, and evaluate medical necessity and/or care plan compliance, options, and services required to support members in managing their health, chronic illness, or acute illness.
- Utilizes available resources to promote quality, cost effective outcomes.
- Performs medical or behavioral review/authorization process.
- Ensures coverage for appropriate services within benefit and medical necessity guidelines.
- Assesses service needs, develops and coordinates action plans in cooperation with members, monitors services and implements plans.
- Evaluates outcomes of plans, eligibility, level of benefits, place of service, length of stay, and medical necessity regarding requested services and benefit exceptions.
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Managed Care Coordinator
24 hours ago
Columbia, United States Mindlance Full timeJob Title: Managed Care Coordinator Job Location: Columbia, SC Top 3/5 Skills: RN / Registered Nurse License Chronic condition care Case Management Job Responsibilities Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established...
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Managed Care Coordinator
4 days ago
Columbia, United States Mindlance Full timeJob Title: Managed Care Coordinator Job Location: Columbia, SC Top 3/5 Skills: · RN / Registered Nurse License · Chronic condition care · Case Management Job Responsibilities Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical...
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In Home Care Coordinator
7 days ago
Columbia, United States Phoenix Home Care and Hospice Full timeJob DescriptionJob DescriptionPhoenix Home Care and Hospice is a leading provider of home care services in the Hospital & Health Care industry. We are currently seeking a motivated and compassionate In Home Care Coordinator to join our dedicated team. As an In Home Care Coordinator, you will play a key role in ensuring the delivery of high-quality care to...
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Quality Coordinator I
2 days ago
Columbia, United States FLASH Technology Group Full timeThe Quality/Ticket Coordinator I, as part of a 24x7 Service Desk, perform the activities associated with the management of dedicated ticket queues to include prioritization of work and assignment to technical resources for resolution of end user concerns while ensuring service levels and objectives are met. Responsibilities include: -Monitoring dedicated...
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Managed Care Coordinator
13 hours ago
West Columbia, United States Mindlance Full timeJob Title: Managed Care Coordinator Job Location: Columbia, SC Top 3/5 Skills: · RN / Registered Nurse License · Chronic condition care · Case Management Job Responsibilities Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and...
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In Home Care Coordinator
1 week ago
Columbia, Missouri, United States Phoenix Home Care and Hospice Full timePhoenix Home Care and Hospice is a leading provider of home care services in the Hospital & Health Care industry. We are currently seeking a motivated and compassionate In Home Care Coordinator to join our dedicated team. As an In Home Care Coordinator, you will play a key role in ensuring the delivery of high-quality care to our clients while upholding our...
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Private Duty Care Coordinator
1 month ago
Columbia, United States Phoenix Home Care and Hospice Full timeJob DescriptionJob DescriptionPhoenix Home Care and Hospice in Columbia, MO is looking for a Private Duty Care Coordinator!Are you a team player with a heart for people? Are you cool under pressure? Are you organized and fun to work with even in a fast paced environment? Then Phoenix Home Care and Hospice might want to hear from you! This position offers the...
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Clinical Donation Coordinator I
2 weeks ago
West Columbia, United States Sharing Hope SC Inc Full timeClinical Donation Coordinator I Job Details Job Location Columbia - West Columbia, SC Description Summary The Clinical Donation Coordinator (CDC I) responds to referrals of potential organ donors and is responsible for evaluating and setting the plan for medical management for optimal organ function to obtain and assure effective organ donation. Essential...
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Columbia, United States Flash Technology Group LLC Full timeThe Quality/Ticket Coordinator I, as part of a 24x7 Service Desk, perform the activities associated with the management of dedicated ticket queues to include prioritization of work and assignment to technical resources for resolution of end user concerns while ensuring service levels and objectives are met. Responsibilities include: -Monitoring dedicated...
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Account Manager I
1 day ago
Columbia, United States Computershare Full timeSpends the majority of working time performing independent work as part of a team. Uses existing processes and procedures to solve routine or standard problems. May act as a lead on small projects, coordinating and faci **ocation: Columbia, MD (Hybrid)** This is a hybrid position primarily based in Columbia, MD. We’re committed to your flexibility and...
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Private Duty Care Coordinator
1 month ago
Columbia, Missouri, United States Phoenix Home Care and Hospice Full timePhoenix Home Care and Hospice in Columbia, MO is looking for a Private Duty Care Coordinator! Are you a team player with a heart for people? Are you cool under pressure? Are you organized and fun to work with even in a fast paced environment? Then Phoenix Home Care and Hospice might want to hear from you! This position offers the right candidate a...
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Clinical Donation Coordinator I
2 weeks ago
West Columbia, United States We Are Sharing Hope SC Full timeJob DetailsJob Location Columbia - West Columbia, SC DescriptionSummary The Clinical Donation Coordinator (CDC I) responds to referrals of potential organ donors and is responsible for evaluating and setting the plan for medical management for optimal organ function to obtain and assure effective organ donation. Essential Duties & Responsibilities ...
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Accountant I
1 month ago
Columbia, United States SC Student Loan Full timeJob DescriptionJob DescriptionThe Accountant I is responsible for performing administrative financial functions in the Financial Services department. This position will report to the Vice President of Finance with minimal supervision. This position will apply accounting principles and practices to a range of accounting, budgeting, and other fiscal functions....
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Coordinator, Managed Care II/CM-DM
1 week ago
Columbia, United States LanceSoft Full timeReviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/analysis, and comprehensive knowledge of healthcare...
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Coordinator, Managed Care II/CM-DM
1 day ago
Columbia, United States Mindlance Full timeDuties: Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/analysis, and comprehensive knowledge of...
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Care Coordinator, System of Care Across TN
2 weeks ago
Columbia, United States Mental Health Cooperative Full timeRanked one of Tennessee’s top places to work, MHC is a rare and special place where outstanding company culture is intentional. Where clients and associates are treated the same, as equals.Mental Health Cooperative, Inc. (MHC) was formed in 1993 to serve individuals with severe and persistent mental illness. Since then, we have expanded our services to...
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Care Coordinator, System of Care Across TN
2 weeks ago
Columbia, United States Mental Health Cooperative Full timeRanked one of Tennessee’s top places to work, MHC is a rare and special place where outstanding company culture is intentional. Where clients and associates are treated the same, as equals.Mental Health Cooperative, Inc. (MHC) was formed in 1993 to serve individuals with severe and persistent mental illness. Since then, we have expanded our services to...
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Care Coordinator, System of Care Across TN
1 week ago
Columbia, United States Mental Health Cooperative Full timeRanked one of Tennessee’s top places to work, MHC is a rare and special place where outstanding company culture is intentional. Where clients and associates are treated the same, as equals. Mental Health Cooperative, Inc. (MHC) was formed in 1993 to serve individuals with severe and persistent mental illness. Since then, we have expanded our services to...
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Patient Care Coordinator
1 month ago
Columbia, United States Gastro Center of Maryland Full timeGastro Center of Maryland has an opening for a Full-Time Patient Care Coordinator. Must have experience in a fast-paced medical environment. Must have exceptional customer service skills, excellent communication skills to schedule appointments, attention to detail and possess a good work ethic. The PCC is responsible for increasing customer satisfaction and...
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Client Advocate I
4 weeks ago
Columbia, United States Hansen Talent Group Full timeJob DescriptionJob DescriptionHansen Talent Group is hiring a Client Advocate to work with a large enterprise in Columbia, SC. This is a hybrid opportunity and will require 3 days/week onsite.Duties:Responsible for establishing, building, and maintaining sustainable customer relationships. Ensures appropriate customer communication, customer focus, and...