Managed Care Coordinator
2 weeks ago
A Hospital in Van Nuys is looking for a Managed Care Coordinator to work in its Managed Care Department. The right person for this role must have 5+ years of experience with managed care in a hospital setting.
Duties:
• Responsible for negotiating ancillary and health plan agreements on behalf of the hospital
• Negotiates and processes one-time agreements (MOUs, LOAs, etc.) for our network cases
• Direct knowledge and experience with State and Federal laws and regulations pertinent to healthcare including HIPAA, Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS), CMS, etc
• Strong leadership and negotiation skills
• Knowledge of managed care contracting rates for network providers, services, and facilities
• Ability to operate well under high-stress conditions and be extremely organized, paying high attention to detail
• Ability to read, analyze and interpret common industry related journals, financial reports and legal documents
• Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community
• Advanced ability to operate computers and related software for Microsoft programs including Word, Excel, Outlook and accounting software
• Ability to write reports and business correspondence and effectively present information to top management, clients, external groups and/or boards of directors
• Track and trend CAP member performance collaborating with Management Service Organization
• Participate in JOC meetings
• Contract modelling
• Advanced ability to operate computers and related software for Microsoft programs including Word, Excel, Outlook and accounting software
• Review and prepare documentation for CAP potential legal cases
• Proficiency in using EHR (Electronic Health Records) SYSTEM is essential.• Must possess the ability to handle Appeals effectively.
• Experience in Negotiating Contracts within the healthcare sector is required.
• Should have a proven track record in Manage Care Contracting.
• Ability to Manage Care Contracts is mandatory.
• Experience in Medicaid Manage Care is preferred.
• Should be able to develop and Manage Care Plans effectively.
• Familiarity with the Manage Care Industry and its dynamics is necessary.
• Experience in Medical Billing is an added advantage.
-
Enhanced Care Management Coordinator II
3 weeks ago
Los Angeles, United States L.A. Care Health Plan Full timePress Tab to Move to Skip to Content Link Select how often (in days) to receive an alert: Enhanced Care Management Coordinator II Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 11766 Salary Range: $50,216.00(Min.) -$62,770.00(Mid.) -$75,324.00(Max.) Established in 1997, L.A....
-
Care Management Coordinator
2 months ago
Los Angeles, United States Gracelight Community Health Full timeJob DetailsJob LocationLos Angeles, CAPosition TypeFull TimeSalary Range$21.84 - $33.26 HourlyDescriptionThe Care Management Coordinator is responsible for supporting the Clinical Care Manager by outreaching patients/caregivers, providers, Community Based Organizations (CBO), and others to help assist our highest need members into the Care Management (CM),...
-
Care Management Coordinator
2 weeks ago
Los Angeles, United States Gracelight Community Health Full timeJob DetailsJob Location Los Angeles, CA Position Type Full Time Salary Range $21.84 - $33.26 Hourly Description The Care Management Coordinator is responsible for supporting the Clinical Care Manager by outreaching patients/caregivers, providers, Community Based Organizations (CBO), and others to help assist our highest need members into the Care Management...
-
Care Coordinator for Chronic Care Management
3 weeks ago
Los Angeles, California, United States JWCH Institute Full timeJob OverviewWe are seeking a dedicated Care Coordinator to join our team at JWCH Institute, Inc.About the Role:The Care Coordinator will provide comprehensive case management services to patients with multiple chronic conditions, frequent ER visits or inpatient admissions, or those experiencing homelessness.Key Responsibilities:Collaborate with healthcare...
-
Hemodialysis Care Coordinator
3 weeks ago
Los Angeles, California, United States Fresenius Medical Care Full timeFresenius Medical Care, a leading provider of kidney care services, is seeking a skilled and compassionate Hemodialysis Care Coordinator to join our team.About the Role:As a Hemodialysis Care Coordinator, you will play a vital role in ensuring the safe and effective delivery of hemodialysis therapy to patients. Your primary responsibility will be to assess,...
-
Managed Care Coordinator
3 days ago
Los Angeles, California, United States MedPOINT Management Full timeRole SummaryMedPOINT Management seeks an experienced Managed Care Coordinator to join our team. As a key member of our Provider Network Operations, you will serve as the liaison between our clients, contracted providers, and health plans. Your primary responsibilities will include executing provider onboarding, update, and termination processes, ensuring...
-
Personal Care Coordinator
3 days ago
Los Angeles, California, United States CALMING PALMS HOME CARE LLC Full timeAbout the RoleWe are seeking a highly skilled and compassionate Personal Care Coordinator to join our team at Calming Palm's Home Care LLC. As a Personal Care Coordinator, you will be responsible for coordinating and delivering high-quality care services to our clients in their homes.The estimated salary for this role is $55,000 - $70,000 per year,...
-
Care Coordinator
3 weeks ago
Los Angeles, United States Elevance Health Full timeAnticipated End Date: 2024-12-11 Position Title: Care Coordinator Job Description: Care Coordinator Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point location. Work schedule: Monday – Friday 8:00am to 5:00pm depending on your zone. A proud member of the Elevance Health family of companies,...
-
Care Coordinator
6 hours ago
Los Angeles, California, United States JWCH Institute Full timeJob Title: Care Coordinator About the Job: We are seeking a skilled Care Coordinator to join our team at JWCH Institute. As a key member of our care management team, you will be responsible for providing comprehensive care coordination services to eligible patients, ensuring a seamless experience and preventing duplication of services.About You: To be...
-
Care Coordinator
2 weeks ago
Los Angeles, United States Visiting Angels Full timeJob Summary: We are seeking a Care Coordinator to join our team. In this role, you will work collaboratively with patients to determine their medical needs, develop the best course of action, and oversee their treatment plans, ensuring each client gets high-quality, individualized care. The ideal candidate is compassionate, reliable, trusted, and...
-
Los Angeles, California, United States Kaiser Permanente Full timeKaiser Permanente is a leading health care organization seeking an experienced Registered Nurse to join our team as a Clinical Care Coordinator for Utilization Management. This exciting opportunity offers a challenging and rewarding career path with opportunities for growth and professional development.About the Role:We are looking for a highly skilled and...
-
Respiratory Care Coordinator
4 weeks ago
Los Angeles, United States Kaiser Permanente Full timeJob Summary: Assists in the planning, development, and implementation of Respiratory Care programs, and or education, for inpatient or outpatient staff. Will coordinate high quality, cost-effective care for patient population with COPD, asthma, Cystic Fibrosis, sleep disorders, and home oxygen. Coordinates all aspects of Respiratory Care, and or Respiratory...
-
Care Coordinator
7 months ago
Los Angeles, United States HOPICS Full timeSPECIAL SERVICE FOR GROUPSOB ANNOUCEMENTTitle: Care Coordinator Division: HOPICSFLSA: Non-Exempt, Full time Supervisor: RRH/Prevention...
-
Per Diem Patient Service Representative
2 weeks ago
Los Angeles, United States Academy of Managed Care Pharmacy Full timeDescription As a part of the Ambulatory Float Pool Team, you provide administrative and patient care support to various ambulatory practices. Duties include, but are not limited to: Assisting in coordinating patient flow throughout the clinic, from registration to discharge. Processing prior authorizations and completing Surgery Scheduling tasks. Working as...
-
Geriatric Care Coordinator
2 days ago
Los Angeles, United States A-BIZ INC Full timeJob OverviewA-BIZ INC is seeking a highly skilled Registered Nurse to fill the role of Geriatric Care Coordinator. This position involves coordinating and managing the care of elderly or disabled individuals participating in the Assisted Living Waiver Program.The ideal candidate will have a strong background in geriatric nursing, case management, and care...
-
Care Coordinator
2 days ago
Los Angeles, California, United States Special Service for Groups, Inc- HOPICS Full timeAbout the RoleWe are seeking a highly skilled and compassionate Care Coordinator to join our team at Special Service for Groups, Inc - HOPICS. This is a full-time position that requires excellent communication and interpersonal skills, with a strong focus on providing exceptional support to our clients.Key ResponsibilitiesProvide client care and service...
-
Care Coordinator
7 days ago
Los Angeles, California, United States Spread Your Wings, LLC. Full timeJob OverviewThe Care Coordinator position is an excellent opportunity for experienced professionals to join our team in Los Angeles and provide Supportive Living Services to intellectually disabled clients.About the RoleWe are seeking a skilled Care Coordinator to support the delivery of high-quality services to individuals with intellectual disabilities....
-
Patient Service Representative
2 weeks ago
Los Angeles, United States Academy of Managed Care Pharmacy Full timeDescription In this position, you will provide administrative and patient care support to various ambulatory practices. You will assist in coordinating patient flow throughout the clinic, from registration to discharge, process prior authorizations, and complete Surgery Scheduling tasks. You will work as a member of the Ambulatory Care clinic team to provide...
-
Continuum of Care Coordinator
1 week ago
Los Angeles, California, United States Martin Luther King, Jr. Community Hospital Full timeOverviewMartin Luther King, Jr. Community Hospital is a vibrant healthcare organization dedicated to providing high-quality, patient-centered care. Our team of compassionate professionals is committed to making a positive impact in the lives of our patients and community.Job DescriptionThis is an exciting opportunity for a skilled Care Manager to join our...
-
Care Coordinator Specialist
4 weeks ago
Los Angeles, California, United States MedPOINT Management Full timeJob OverviewWe are seeking a skilled Care Coordinator Specialist to join our team at MedPOINT Management. In this role, you will play a critical part in coordinating care for cases assigned to Nurse Case Managers.ResponsibilitiesThe successful candidate will be responsible for:Opening and closing cases efficientlyCompleting and closing tasks...