Managed Care Coordinator

Job Title: Care Management Associate / Care Coordination Associate Location: New York, NY 10004 Shift: Monday – Friday | 9:00 AM – 5:00 PM Contract Duration: 2 Months with a strong possibility of extension Pay Rate: $20 – $25/hr Key Responsibilities: • Manage daily member intake workflow and maintain accurate membership records • Handle inbound and outbound calls regarding member services and care coordination • Schedule appointments for care management staff and assist members with medical appointments • Enter authorizations and prior approvals into healthcare application systems • Coordinate with HHA/PCA/PCS/CDPAP vendors regarding member services and care updates • Monitor authorization queues to ensure timely processing of requests • Track hospital admissions, ER visits, nursing home stays, and member status updates • Review documentation for completeness, accuracy, and resolve discrepancies • Process faxes, update member records, and maintain organized files Required Qualifications: • Experience in managed care, MLTC, or healthcare coordination • Knowledge of ICD-9 and CPT-4 codes • Experience with authorization systems or healthcare applications • High School Diploma or GED • 1+ year of customer service, call center, or healthcare experience • Basic understanding of medical terminology “Pride Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.”