Managed Care Coordinator

Job Summary

A company is looking for a Managed Care Coordinator I to support Clinical Operations functions and liaise between members, physicians, and operational teams.

Key Responsibilities:

• Review service requests for completeness and gather necessary clinical and non-clinical data
• Prepare and document cases for clinical review, coordinating with members and providers
• Assist members with finding providers and resolving issues related to services and claims

Required Qualifications:

• High School Diploma/GED required
• 1-2 years of experience in customer service or a medical support role preferred
• Knowledge of medical terminology preferred
• Familiarity with Managed Care principles preferred
• Ability to use a personal computer and applicable software and systems