Managed Care Coordinator

Job Summary

Supporting Clinical Operations, the full-time Managed Care Coordinator will manage service requests, coordinate with members and providers, and assist in case management activities in a remote environment.

Key responsibilities:

• Perform reviews of service requests for completeness and gather necessary clinical and non-clinical data
• Act as a liaison between members, physicians, and care managers while handling inquiries and coordinating benefits
• Assist members in accessing services, resolving issues, and completing health assessments

Required qualifications:

• High School Diploma or GED required
• 1-2 years of experience in customer service or a medical support role preferred
• Knowledge of medical terminology and managed care principles preferred
• Ability to make sound decisions under supervision
• Proficiency in using personal computers and applicable software