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Managed Care Coordinator

7/10/2025

Remote

Job Summary

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

Key Responsibilities:
  • Review service requests for completeness and collect necessary clinical and non-clinical data
  • Prepare and document cases for clinical review, coordinating with members and providers
  • Assist members with provider access, problem resolution, and health assessments


Required Qualifications:
  • High School Diploma/GED required
  • 1-2 years of experience in customer service or a medical support-related role preferred
  • Knowledge of medical terminology required; Medicaid CM knowledge preferred
  • Familiarity with contracts, enrollment, billing, and claims coding/processing preferred
  • Understanding of Managed Care principles preferred

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