Managed Care Coordinator

Work Location: Orange, California

About the role

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.

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.

Responsibilities

• Review, analyze, and implement managed care contracts and products
• Organize and implement managed care educational forums
• Lead interdepartmental teams in operationalizing managed care contracts
• Resolve identified managed care operational issues
• Participate 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

Qualifications

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

Work Environment

Functional Demand: 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, standing, talk or hear, taste or smell, twisting, walking, wrist position deviation
• Lifting (Floor to waist level): Constant 67% or more, Frequent 36-66%, Occasional 0-35%
• Lifting (Waist level and above): Constant 67% or more, Frequent 36-66%, Occasional 0-35%

Sensory Requirements

• Color discrimination, depth perception, far vision, hearing, near vision

Environment Requirements

• Airborne communicable disease, bloodborne pathogens, chemical, dust particulate matter, extreme noise levels, extreme temperatures, radiation, uneven surfaces or elevations

Benefits

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