Managed Care Coordinator
4 weeks ago
It's inspiring to work with a company where people truly BELIEVE in what they're doing When you become part of the Chapters Health Team, you'll realize it's more than a job. It's a mission. We're committed to providing outstanding patient care and a high level of customer service in our communities every day. Our employees make all the difference in our success Role: The Managed Care Coordinator (MCC) is responsible to coordinate and disseminate pertinent information regarding all Medicare Advantage, Managed Medicaid and large Managed Care provider patients. In this role, the Managed Care Coordinator works with the Patient Support staff, Billing and Finance team, and Clinical Liaisons. The MCC acts as a liaison between the Company and the Physician Group Case Managers. Creates and maintains relationships and communication with local area managed care groups and their case management professionals. The MCC is involved in organizing, tracking and reporting of key patient demographic information in a reporting tool for the managed care referral sources. Qualifications: * Associate's degree with three (3) years of relevant experience or five (5) years' experience in a related field or an equivalent combination of education and experience * Knowledge of medical terminology * Bilingual preferred * Requires Strong Oral and Written Communication and Interpersonal skills * Requires ability to make sound decisions under the limited direction of Supervisor * Requires strong knowledge of managed healthcare business, within a primary care physician practice setting. One (1) or more years of actual relevant experience preferred. * Strong proficiency in Microsoft applications including Outlook, Word, and Excel * Proficiency with AllScripts; EHR preferred * Demonstrated ability to analyze complex data and resolve problems with minimal supervision * Excellent business judgment and time management/prioritization skills * Intermittent Driver - Valid driver's license and automobile insurance per Company policy Competencies: * Satisfactorily complete competency requirements for this position. Responsibilities of all employees: * Represent the Company professionally at all times through care delivered and/or services provided to all clients. * Comply with all State, federal and local government regulations, maintaining a strong position against fraud and abuse. * Comply with Company policies, procedures and standard practices. * Observe the Company's health, safety and security practices. * Maintain the confidentiality of patients, families, colleagues and other sensitive situations within the Company. * Use resources in a fiscally responsible manner. * Promote the Company through participation in community and professional organizations. * Participate proactively in improving performance at the organizational, departmental and individual levels. * Improve own professional knowledge and skill level. * Advance electronic media skills. * Support Company research and educational activities. * Share expertise with co-workers both formally and informally. * Participate in Quality Assessment and Performance Improvement activities as appropriate for the position. Job Responsibilities: * Reviews daily referral and admission reports. Identifies status of Managed Care/Physician Office referrals (including Admissions, Referrals Not Admitted, and Deferred Admissions). * Initiates the communication of new admissions, level of care changes and clinical updates to appropriate physician group case managers utilizing their preferred contact methods. * Ensures all new patient admissions PCP, manage care group and health plan affiliations have been documented appropriately in EMR. * Establishes and maintains relationships with managed care office designee, i.e., case manager, office manager, physician provider. * Maintains and updates master list of managed care office designees, including names, phone numbers, email addresses and preferred contact methods including feedback from Clinical Liaisons and Managed Care partners. * Reviews level of care changes of managed care patients, including clinical notes, as identified by ACE notification * Ensures all managed care patient consents, advance directives, DNROs, clinical notes and initial assessment/guidelines are distributed to the appropriate managed care office designee, based on the preference of the Physician Group. * Works with Business Development leadership, compiling monthly reports of all managed care patients for Physician groups as well as other key accounts as requested. * Follows all policies and procedures and meets all HR and educational requirements. * Participates and adheres to all quality improvement and compliance programs. * Responsible for MyUnity documentation and account assignment per direction of the Business Development Directors. * Performs other duties as assigned. This position requires consent to drug and/or alcohol testing after a conditional offer of employment is made, as well as on-going compliance with the Drug-Free Workplace Policy.
-
Long Term Care Coordinator
3 weeks ago
FORT MYERS, United States Centene Corporation Full timeYou could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. **Position Purpose:** Responsible for members gaining access to needed...
-
Long Term Care Coordinator
1 week ago
FORT MYERS, United States Centene Corporation Full timeYou could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. **Position Purpose:** Responsible for members gaining access to needed...
-
Care Manager
2 weeks ago
Fort Myers, United States Brookdale Senior Living Full timeCare Manager - RNCare Manager - RN Overview WHY Brookdale- Our culture of compassionate and caring extends to everyone, our associates, our residents and their families. Our cornerstones of passion courage, partnership and trust drive everything we do and come to life every day in our communities Not sure if Brookdale is for you? Come see the Brookdale...
-
Care Manager
1 week ago
Fort Myers, United States Brookdale Senior Living Full timeCare Manager - RNCare Manager - RN Overview WHY Brookdale- Our culture of compassionate and caring extends to everyone, our associates, our residents and their families. Our cornerstones of passion courage, partnership and trust drive everything we do and come to life every day in our communities Not sure if Brookdale is for you? Come see the Brookdale...
-
Care Manager
1 day ago
Fort Myers, United States Brookdale Senior Living Full timeCare Manager - RNCare Manager - RN Overview WHY Brookdale- Our culture of compassionate and caring extends to everyone, our associates, our residents and their families. Our cornerstones of passion courage, partnership and trust drive everything we do and come to life every day in our communities Not sure if Brookdale is for you? Come see the Brookdale...
-
RN Care Management
2 months ago
Fort Myers, FL, United States US Renal Care Full timeRN, Market Management, Value-Based Care - Fort Myers The Value-Based Care Management Registered Nurse interacts in-person and telephonically with chronic kidney disease patients, families, and support networks to provide comprehensive assistance in all areas related to ongoing education, medical history, medications, development of support systems,...
-
RN, Market Management, Value-Based Care
2 months ago
Fort Myers, United States US Renal Care Full timeRN, Market Management, Value-Based Care - Fort MyersThe Value-Based Care Management Registered Nurse interacts in-person and telephonically with chronic kidney disease patients, families, and support networks to provide comprehensive assistance in all areas related to ongoing education, medical history, medications, development of support systems, lifestyle...
-
Care Coordinator
2 weeks ago
Fort Myers, United States Integrity Placement Group Full timeCare Coordinator Our client is in beautiful Fort Myers, FL and looking for qualified professionals to join their team! They are a well establish non-profit that brings much needed services to the community.The Position: Our client is looking for a Care Coordinator to join their established team in the Fort Myers area. They are offering the following...
-
Care Coordinator
3 weeks ago
Fort Myers, United States Integrity Placement Group Full timeCare Coordinator Our client is in beautiful Fort Myers, FL and looking for qualified professionals to join their team! They are a well establish non-profit that brings much needed services to the community. The Position: Our client is looking for a Care Coordinator to join their established team in the Fort Myers area. They are offering the following...
-
Care Coordinator
6 days ago
Fort Myers, United States Integrity Placement Group Full timeCare Coordinator Our client is in beautiful Fort Myers, FL and looking for qualified professionals to join their team! They are a well establish non-profit that brings much needed services to the community.The Position: Our client is looking for a Care Coordinator to join their established team in the Fort Myers area. They are offering the following...
-
Care Coordinator
1 week ago
Fort Myers, United States Integrity Placement Group Full timeCare Coordinator Our client is in beautiful Fort Myers, FL and looking for qualified professionals to join their team! They are a well establish non-profit that brings much needed services to the community. The Position: Our client is looking for a Care Coordinator to join their established team in the Fort Myers area. They are offering the following...
-
Patient Care Coordinator
6 days ago
Fort Myers, United States Breakthrough Health Centers Full timeJob DescriptionJob DescriptionDiscover the opportunity of a lifetime as a Patient Care Coordinator at Breakthrough Health Centers! This isn't just a job; it's a chance to transform lives. We're seeking a dedicated professional for this full-time position, which includes travel between our Fort Myers and Bonita Springs offices. If you're...
-
Coordinator, Student Care Services
2 days ago
Fort Myers, United States CareerBuilder Full timeJob Summary The Coordinator, Student Care Services addresses the needs of students who are experiencing difficulties related to mental health, physical health and/or psycho-social adjustment, personal and family emergencies, financial challenges or who need general assistance. The Coordinator, Student Care Services provides guidance for students to navigate...
-
Coordinator, Student Care Services
3 weeks ago
Fort Myers, Florida, United States Florida Gulf Coast University Full timeJob SummaryThe Coordinator, Student Care Services addresses the needs of students who are experiencing difficulties related to mental health, physical health and/or psycho-social adjustment, personal and family emergencies, financial challenges or who need general assistance. The Coordinator, Student Care Services provides guidance for students to navigate...
-
Coordinator, Student Care Services
3 weeks ago
Fort Myers, United States Florida Gulf Coast University Full timeJob SummaryThe Coordinator, Student Care Services addresses the needs of students who are experiencing difficulties related to mental health, physical health and/or psycho-social adjustment, personal and family emergencies, financial challenges or who need general assistance. The Coordinator, Student Care Services provides guidance for students to navigate...
-
Coordinator, Student Care Services
1 week ago
Fort Myers, Florida, United States Florida Gulf Coast University Full timeJob SummaryThe Coordinator, Student Care Services addresses the needs of students who are experiencing difficulties related to mental health, physical health and/or psycho-social adjustment, personal and family emergencies, financial challenges or who need general assistance. The Coordinator, Student Care Services provides guidance for students to navigate...
-
Coordinator, Student Care Services
1 week ago
Fort Myers, United States Florida Gulf Coast University Full timeJob SummaryThe Coordinator, Student Care Services addresses the needs of students who are experiencing difficulties related to mental health, physical health and/or psycho-social adjustment, personal and family emergencies, financial challenges or who need general assistance. The Coordinator, Student Care Services provides guidance for students to navigate...
-
Ambulatory RN Care Coordinator Oncology
1 month ago
Fort Myers, Florida, United States Lee Health Full timeLocation:The Sanctuary - Regional Cancer Center -8931 Colonial Center DriveFort Myers FL 33905Department: LCH Oncology PhysiciansWork Type: Full TimeShift: Shift 1/8:00:00 AM to 4:30:00 PMMinimum to Midpoint Pay Rate:$ $42.90 / hourSummaryThe Regional Cancer Center, part of Lee Health, is seeking an experienced RN to join their Oncology Team. This Ambulatory...
-
Ambulatory RN Care Coordinator Oncology
1 week ago
Fort Myers, Florida, United States Lee Health Full timeLocation:The Sanctuary - Regional Cancer Center -8931 Colonial Center DriveFort Myers FL 33905Department: LCH Oncology PhysiciansWork Type: Full TimeShift: Shift 1/8:00:00 AM to 4:30:00 PMMinimum to Midpoint Pay Rate:$ $42.90 / hourSummaryThe Regional Cancer Center, part of Lee Health, is seeking an experienced RN to join their Oncology Team. This Ambulatory...
-
Patient Care Manager Assistant
1 month ago
Fort Myers, United States Mederi Caretenders Full timeWe are hiring a Patient Care Manager Assistant! The Home Health Patient Care Manager Assistant is responsible for assisting the Patient Care Manager in coordinating a team of staff to assure the continuity of high quality care to home health patients assigned to the team's area. This includes ensuring all team staff are skilled and informed and that they...
