Managed Care Coordinator
$49.72k - $92.47kAdventHealth
Our promise to you Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule Full time Shift Day (United States of America) Address
2600 LUCIEN WAY
CityMAITLAND
State Florida Postal Code 32751 Job Description Analyzes managed care contracts to ensure compliance with organizational standards and regulatory requirements. Negotiates contract terms with payors to secure favorable reimbursement rates and conditions. Reviews and updates fee schedules and contract modifications to reflect current rates and terms. Communicates contract changes and updates to relevant internal departments and stakeholders. Collaborates with clinical and support staff to optimize reimbursement and reduce operational overhead. Monitors payor compliance with contractual obligations and addresses any discrepancies. Maintains accurate and up-to-date records of all managed care contracts and related documentation. Provides training and support to staff on managed care contract requirements and changes. Facilitates open communication and joint decision-making with payors and internal teams. Builds and maintains relationships with payors to ensure effective contract management. Resolves any issues or conflicts related to managed care contracts in a timely manner. Participates in performance improvement initiatives related to managed care processes. Other duties as assigned. Knowlege, Skills, and Abilities General knowledge of healthcare, hospital and provider operations, and managed care payer contracts and operations. [Required] Must have a high degree of understanding of the managed care payers and managed care contracting requirements. [Required] Knowledge of healthcare, hospital/provider operations and managed care payer operations. [Required] Education Bachelor's [Preferred] Field of Study from a four-years college or university Work Experience 3+ years of managed care or position-related experience [Required] 5+ years of position-related experience [Preferred] Physical Requirements (Please click the link below to view work requirements) Physical Requirements - Pay Range $49,718.59 - $92,468.74 Background Screening Requirement (Florida Law) Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law. Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse: This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. #J-18808-Ljbffr AdventHealth- ...AdventHealth Maitland, FL is seeking a strategic healthcare contracting professional to advance managed care initiatives. You will evaluate opportunities, develop negotiation strategies, and drive contract outcomes with health plans. The role requires strong leadership...SuggestedFull timeContract workWork at officeRemote work
- ...Point Of Care Coordinator Location: Tallahassee, FL Salary: 30-40/hr Position Summary: We are looking for a Point of Care Coordinator to oversee and manage the point-of-care testing and quality assurance processes within our facility. This role ensures that all...SuggestedRelocation package
- ...: Summary: The Transcranial Magnetic Stimulation (TMS) Care Coordinator serves as the primary point of contact for patients throughout... ...consultations, providing education regarding TMS therapy, managing insurance verification and prior authorizations, coordinating...Suggested
$18 - $20 per hour
...Patient Coordinator – Help Guide the Patient Journey! Are you passionate about helping... ...role in delivering exceptional patient care and support! This is your opportunity... ...patient care are coordinated effectively Manage referrals, tests, procedures, and timely...SuggestedHourly payFull timeTemporary workWork at officeRemote workMonday to FridayFlexible hours- ...Summary:The Care Coordinator coordinates services for women and parents of infants who were screened for or referred to Healthy Start.Essential... ...quality standards.Professional work documentation and time management skills.Develop and maintain good working knowledge of the...SuggestedTemporary workWork at office
$46.92k
...changing career, couples reside in on-campus student homes and provide care, guidance, supervision, and support for a group of approximately... ...include: Providing daily supervision and mentorship Managing household routines and student schedules Administering...Full timeWork from homeRelocationRelocation packageFlexible hoursWeekday work- ...A 288-bed acute care facility in Tallahassee is seeking a Registered Nurse Case Manager to join its care coordination team. The facility provides 24/7 emergency services and a wide range of specialty programs, including Behavioral Health, Neonatal Intensive Care, Stroke...Full timeRelocation packageFlexible hoursWeekend workDay shift
$67.39k - $107.8k
...application process. Social Services Active - EXEC Full time full-time Management Opa Locka, FL, US 3 days ago Requisition ID: 1325 Salary Range... ..., and federal agencies, as well as nonprofit partners, to coordinate services and share resources. Leads public outreach and...Full timeFor contractorsWork at officeLocal areaFlexible hoursAfternoon shift- Milton Hershey School, a cost-free pre-K through 12th grade residential school, is seeking a Youth Development Specialist in the Education, Training & E-Learning department. This role supports students’ academic, social, and emotional growth through mentoring, small-group...
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- ...Hospice in Florida seeks an experienced RN Case Manager to join a compassionate team delivering patient- and family-centered end-of-life care. You will conduct comprehensive assessments, develop and revise the care plan, coordinate with the IDG, participate in care planning,...
- ...Clinical Case Manager Are you a licensed healthcare professional with a passion for improving outcomes, coordinating complex care, and helping individuals achieve their healthiest lives? Capital Health Plan is seeking a dedicated Clinical Case Manager to join our team...Full timeTemporary workWork at office
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...Clinical Case Manager Lawyer Regulation - Tallahassee, FL | Headquarters Salary commensurate... ...Program (PSLF). Summary function: Coordinates and administers the evaluation and... ...health professionals to ensure seamless care. Informs the Division Director and/or...Work experience placementWork at office- ...timeSchedule: As requiredAbout the role: We are seeking a Quality Care Manager to support Capital Health Plan's clinical quality, patient... ...patient safety.The Quality Care Manager plays a key role in coordinating peer review activities, conducting medical record reviews,...
- Position Summary:The Case Manager Supervisor provides leadership and oversight to a team of... ...use, mental health, and primary care disordersKnowledge and application of developmental... ...in major life areaThe ability to coordinate and integrate multiple services, as well...Work at officeLocal areaImmediate start
$10k
...Join to apply for the Case Manager RN (938796) role at Generis Tek Inc 1 month ago Be among the first 25 applicants Join to apply... ...per 4-week schedule Job Summary and Qualifications: The RN CM Care Coordinator will facilitate the interdisciplinary plan of care with a focus...Permanent employmentFull timeRelocationRelocation packageAll shiftsFlexible hoursShift workWeekend workDay shiftAfternoon shift$31.94 - $43.92 per hour
...Job Description Job Description Care Coordination Perform medical + psychosocial assessments Create and manage discharge plans Coordinate with MDs, nurses, and social workers Lead care planning discussions Utilization Management Review medical necessity...Relocation packageShift workWeekend workAfternoon shift- ...Job Description Job Description Role: Case Manager RN Location: Tallahassee, FL Facility Type: Acute Care (288-bed hospital) Reports to: Director of... ...0 PM Weekend: 1 in every 4 weeks Care Coordination Perform psychosocial + medical assessments...Shift workWeekend workDay shiftAfternoon shift
- ...Case Manager RN The RN CM Care Coordinator will facilitate the interdisciplinary plan of care with a focus on evaluating the appropriateness of clinical care, medical necessity, admission status, level of care, and resource management. The RN CM Care Coordinator will...Permanent employment
- HCA Healthcare is seeking a dedicated Part-Time RN Case Manager to join our diverse team. In this role, you will be instrumental in managing patient care, ensuring that optimal healthcare services are provided in a cost-effective manner. You will work closely with other...Part time
- HCA Healthcare is seeking an RN Case Manager to coordinate patient care across the continuum in our Healthcare & Medical Services department. In this role, you will perform clinical and psychosocial assessments, develop and manage individualized care plans, and ensure...
$31.94 - $43.92 per hour
Immediate need for a talented Case Manager RN. This is a Fulltime opportunity with long-term potential and is located in Tallahassee, FL... ...medical needs of assigned patients Develop case management plan of care including clinical, psychosocial, and discharge needs Assume...Hourly payFull timeLocal areaImmediate startRelocation packageFlexible hoursWeekend workAfternoon shift$31 - $43 per hour
...Job Description Job Description Summary: The Case Manager RN coordinates patient care across the continuum, focusing on medical necessity, appropriate level of care, resource utilization, and safe discharge planning. This role works closely with physicians, interdisciplinary...Relocation packageWeekend workDay shiftAfternoon shift- Big Bend Hospice is seeking an RN Case Manager in Madison, FL 32340 to coordinate and oversee the interdisciplinary plan of care for hospice patients in home or community settings. You will ensure compassionate, high-quality care, develop individualized care plans, manage...
- ...Manager Of Critical Care As the nation's largest private employer of Registered Nurses, we're honored by the trust of over 100,000 nurses... ...Department to improve quality of patient care. Collaborate and coordinate the efforts of the staff of the Department to accomplish...Temporary workFlexible hours
- ...HospiceHospice work is not a job – it's a calling. Caring for patients and their families at the... ...potentialYour Impact As the RN Case Manager, you will perform the initial assessment... ..., and the end-stage disease process.Coordinate care and medications with MD and APRN...Monday to Friday
- ...At HCA Healthcare, we are committed to caring for patients with purpose and integrity.... ...Jump-start your career as a(an) RN Case Manager Part Time today with HCA Florida Capital... ...every step of their care journey. You will coordinate services, connect resources, and develop...Full timeTemporary workPart timeFlexible hours
- ...committed to supporting safe, high-quality care for which they can practice. That’s why... ...Summary and Qualifications As a Case Manager, your role will be to support patients... ...every step of their care journey. You will coordinate services, connect resources, and develop...Temporary workFlexible hours
- ...CVS Health in Florida is seeking a Bilingual Case Manager Analyst to coordinate care, educate members, and facilitate access to services for diverse populations. You will use care management tools and data to assess needs, identify risks, and develop effective care plans...
$72k - $75k
...grow your career with us, experience our caring culture, and enjoy work-life balance.... ...Financial Services & Insurance Telephonic Case Manager **PRIMARY PURPOSE OF THE ROLE:** While... ...through advocacy, communication and coordination of medical services. **ARE YOU AN IDEAL...Full timeWork experience placementRemote workFlexible hours
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