Non Profit Org - Managed Care Coordinator

Universal Community Health Center•Los Angeles, CA

62d•$23 - $25

About The Position

The Managed Care Coordinator is responsible for coordinating and managing the day-to-day activities associated with managed care programs, with a primary focus on monitoring and tracking patient enrollments and disenrollments to reestablish care with the health center and enhancing patient retention efforts. This role involves ensuring compliance with managed care contracts, providing support to patients, healthcare providers. The ideal candidate will have a strong understanding of healthcare systems, excellent organizational skills, and the ability to communicate effectively with various stakeholders.

Requirements

Bachelor's degree in healthcare preferred.
Minimum of 2-3 years of experience in managed care, registration, enrollment, or a related field.
Strong empathy, patience, and a commitment to patient well-being.
In-depth understanding of managed care principles and healthcare reimbursement.
Excellent organizational and time-management skills.
Strong analytical and problem-solving abilities.
Effective communication and interpersonal skills.
Ability to sit or stand for extended periods.
Manual dexterity to operate a computer and other office equipment.
Ability to lift up to 25 pounds as needed.

Nice To Haves

Previous experience in patient engagement, customer service, or healthcare coordination is strongly preferred.
Proficiency with electronic health record (EHR) systems and other healthcare technology platforms (preferred).
Bilingual in Spanish (preferred).

Responsibilities

Monitors and tracks patient enrollments and disenrollments.
Ensures timely re-establishment of care.
Develops strategies to improve patient retention and reduce disenrollment.
Assists patients with re-establishing care, PCP switches, and scheduling with enrollment counselors.
Facilitates patient access to healthcare services.
Addresses patient inquiries and resolves issues related to managed care coverage.
Assists with patient outreach initiatives.
Serves as a liaison between healthcare providers and managed care organizations.
Provides backup support and cross-training for provider enrollment, health plan credentialing, and contracting processes.
Monitors and analyzes managed care data to identify trends.
Prepares regular reports on managed care performance metrics.
Utilizes data to develop strategies for improving operations.
Stays informed about changes in managed care regulations and industry standards.
Ensures compliance with federal, state, and local regulations.
Communicates effectively with patients, providers, insurance companies, and internal teams.
Collaborates with multidisciplinary teams to improve processes.
Participates in relevant meetings and training sessions.