EDUCATION & WORK EXPERIENCE
- A bachelor’s degree in a human services or business-related field is required.
- Must have experience with Managed Care/Insurance.
- Must have basic computer skills, the ability to do spreadsheets and word-processing, excellent verbal and written communication skills.
The Managed Care Coordinator reports to Director of Quality Services and will be the central point of communication with the Medicaid Managed Care Organizations and will monitor all Managed Care initiatives internally and externally. This position will also be responsible for education and training on Managed Care issues, assist with policy review and improvement to meet MCO guidelines, lead company strategy to improve our relationship with the Managed Care Organizations.
DUTIES AND RESPONSIBILITIES
- Develop and maintain outcome database for use in MCO reporting
- Provide Coordination and support for the Managed Care Transition Team
- Monitor Managed Care Initiative development and integrate with Optimae’s processes
- Be the central point of communication for the MCOs
- Provide training and education on Managed Care throughout the company
- Coordinate with IACP and other external stakeholder efforts to implement managed care for Optimae
- Coordinate Managed Care Initiative updates with EHR initiative
- Assist with policy review and policy improvement to meet MCO guidelines
- Lead company strategy meetings which address updates/issues in managing company relationships with MCO partners
- Assist company with troubleshooting with MCOs and funders billing matters
- Attend agency and DHS meetings and trainings from subject matter experts and report back to company on what is learned
- Be a part of company corporate team, which provides guidance to the company on MCO policy, procedures, newsletters, and notices
- Generate educational materials for company on MCO changes and updates
- Assist and support communication with company lobbyist, legislatures and other government entities.
- Other duties as assigned.
- Ability to lift and carry:
- up to 25 lbs. occasionally.
- up to 40 lbs. rarely.
- Ability to climb stairs while carrying objects.
- Normal vision with correction.
- Normal range of hearing with corrections.
- Frequently perform daily duties which involve standing, bending, pivoting, squatting, kneeling, and crouching.
Efforts have been made to make this job description as complete as possible. However, it in no way states or implies that these are the only duties the Managed Care Coordinator will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, or related to the needs of people we serve, or as assigned by supervisory level staff.
To complete an online application, click here.