Managed Care Coordinator

Job Summary

A company is looking for a Managed Care Coordinator I to support Clinical Operations and act as a liaison between members, physicians, and operational teams.

Key Responsibilities

• Review service requests for completeness and gather necessary clinical and non-clinical data
• Prepare and document cases for clinical review, coordinating with members and providers
• Assist members with provider searches, problem resolution, and 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 is required; Medicaid case management knowledge preferred
• Familiarity with contracts, enrollment, and claims coding/processing preferred
• Ability to use personal computers and relevant software applications