Managed Care Coordinator

About the role

At CHOC, we strive to be the leading destination of children’s health by providing exceptional and innovative care. We are responsible for the overall health of our community’s pediatric population in our hospitals, clinics, and practices. And because of our breadth of care, your career at CHOC can be as diverse and fulfilling as you determine.

CHOC’s compensation structure, benefits offerings, and career development programs are geared to helping you achieve your professional and personal goals.

The Managed Care Coordinator assists with the review, analysis and implementation of managed care contracts and products, organizes and implements managed care educational forums. Leads interdepartmental teams in operationalizing managed care contracts and resolving identified managed care operational issues; participates in the development of managed care operations support systems.

Responsibilities

Assists with the review, analysis and implementation of managed care contracts and products

Organizes and implements managed care educational forums

Leads interdepartmental teams in operationalizing managed care contracts and resolving identified managed care operational issues

Participates in the development of managed care operations support systems

Requirements

• Minimum two (2) years of managed care or provider relations experience in the healthcare field
• High School Diploma/ GED or equivalent experience
• Excellent oral and written communication skills
• Proficient in Word, Excel and PowerPoint
• Knowledge of managed care HMO/POS/PPO and Medi-Cal payor structures

Preferred Qualifications

• Three (3) or more years managed care contract administration experience in a hospital setting or health plan
• Bachelor's degree in Healthcare Administration, Business Administration or closely related field
• Excellent oral and written communication skills, to include presenting to groups
• Proficient in Word, Excel, PowerPoint and Access
• Thorough Knowledge and operational experience with commercial and governmental health services payor resources, managed care strategies and basic finance/budget principles

Work Environment and Physical Demands

Sedentary - Very light energy level

Lift 10 lbs. box overhead. Lift and carry 15 lbs. Push/pull 20 lbs. cart.

Physical Activity Requirements: Bending, Carry Objects, Climbing, Keyboard use/repetitive motion, Pinching/fine motor activities, Push/Pull, Reaching forward, Reaching overhead, Sitting, Squat/kneel/crawl (Squad & Knee), Standing, Talk or hear, Taste or smell, Twisting, Walking, Wrist position deviation

Pay

Pay Range: Minimum $64,355, Midpoint $85,259, Maximum $106,184

Rate of pay is determined by various factors, including but not limited to knowledge, skills, competencies, experience, education, as well as position requirements.