Managed Care Coordinator

Job Summary

A company is looking for a Managed Care Coordinator I to support Clinical Operations functions and act as a liaison between various stakeholders.

Key Responsibilities:

• Review service requests for completeness and collect clinical and non-clinical data
• Prepare and document cases for clinical review, coordinating with members and providers
• Assist members in 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 is required; familiarity with Medicaid CM is preferred
• Understanding of managed care principles is preferred
• Ability to use a personal computer and applicable software is preferred