Non Profit Org - Managed Care Coordinator at Universal Community Health Center

Los Angeles, California, United States -

Full Time

Start Date

Immediate

Expiry Date

17 Dec, 25

Salary

0.0

Posted On

18 Sep, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Patient Management, Organizational Skills, Communication Skills, Data Analysis, Problem-Solving, Healthcare Systems Knowledge, Managed Care Principles, Interpersonal Skills, EHR Systems Proficiency, Bilingual in Spanish, Compliance Knowledge, Patient Engagement, Customer Service, Time Management, Analytical Skills, Healthcare Coordination

Industry

Medical Practices

Description

Description 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. General Accountabilities Patient Management: 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. Provider & Credentialing Support: 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. Data Analysis & Reporting: 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. Compliance & Regulation: Stays informed about changes in managed care regulations and industry standards. Ensures compliance with federal, state, and local regulations. Communication & Collaboration: Communicates effectively with patients, providers, insurance companies, and internal teams. Collaborates with multidisciplinary teams to improve processes. Participates in relevant meetings and training sessions. Equal Employment Opportunity Universal Community Health Center is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), age, disability, genetic information, national origin, or any other protected characteristic as defined under applicable state, federal, or local laws. Requirements Qualifications Education: Bachelor's degree in healthcare preferred. Experience: Minimum of 2-3 years of experience in managed care, registration, enrollment, or a related field. Previous experience in patient engagement, customer service, or healthcare coordination is strongly preferred. Skills: 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. Proficiency with electronic health record (EHR) systems and other healthcare technology platforms (preferred). Bilingual in Spanish (preferred). Physical Requirements 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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this job Work Environment Work is primarily performed in clinical and administrative office settings. Entry into clinical areas may require use of personal protective equipment (PPE). Noise level is typically moderate.

Responsibilities

The Managed Care Coordinator is responsible for coordinating and managing day-to-day activities associated with managed care programs, focusing on patient enrollments and retention efforts. This role involves ensuring compliance with managed care contracts and providing support to patients and healthcare providers.