FREE ACCESS
5,000–10,000 jobs/day
See all jobs on Scoutfield
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Care Coordinator, SW BH – Hope
Empower Healthcare Solutions. Oversee and facilitate managed care services, including verifying eligibility, managing referrals, and obtaining authorizations for medical procedures, treatments, and services .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managed care services, including eligibility verification, referral management, and authorization processes. Proficient in delivering health education, collaborating with healthcare providers, and ensuring compliance with regulations while maintaining accurate documentation.
Highest-signal resume keywords
Managed Care PrinciplesHealth Insurance TerminologyOrganizational SkillsCommunication SkillsDocumentation Accuracy
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Eligibility VerificationReferral ManagementAuthorization ProcessesUtilization ReviewsProcess Improvement
Soft Skills
Interpersonal SkillsDetail-OrientedCollaboration
Tools & Technologies
Computer SystemsSoftware Applications
Certifications & Qualifications
Valid Driver's LicenseAutomobile Insurance
Industry Keywords
Social Determinants of HealthPatient SupportQuality Improvement InitiativesHealthcare RegulationsMental Health Field
About the role
Key responsibilities & impact- Oversee and facilitate managed care services, including verifying eligibility, managing referrals, and obtaining authorizations for medical procedures, treatments, and services
- Deliver personalized health education and coaching to members based on identified concerns outlined in treatment and service plans
- Provide member support in addressing social determinants of health, including access to exercise opportunities and nutritious food
- Verify insurance coverage and benefits for patients and document accurate, up-to-date information
- Conduct utilization reviews to evaluate medical necessity and appropriateness of requested services
- Collaborate with insurance companies and healthcare providers to ensure availability and quality of services
- Coordinate with diverse healthcare providers for diagnostics, ambulatory care, and hospital services
- Serve as a point of contact for members, addressing questions, concerns, and complaints and advocating for their needs
- Support outreach, quality improvement initiatives, and patient panel management
- Coordinate community-based management of medication therapy
- Ensure compliance with applicable laws, regulations, contractual obligations, and the PCSP
- Maintain accurate documentation of interactions, authorizations, and communications
- Identify and implement process improvements to optimize service delivery and patient satisfaction
- Collaborate with external and internal stakeholders to improve service efficiency
Requirements
What you’ll need- High School diploma and One (1) year experience in the mental health field
- Bachelor's degree in a relevant field such as healthcare, social work, Psychology or social services and other healthcare related field preferred
- Knowledge of managed care principles, processes, and regulations
- Familiarity with health insurance terminology, coverage, and benefit structures
- Strong organizational skills with the ability to manage multiple tasks simultaneously
- Excellent communication and interpersonal skills to effectively collaborate with internal and external stakeholders
- Detail-oriented and ability to maintain accurate records and documentation
- Proficiency in using computer systems and software applications relevant to managed care operations
- A valid driver's license and up to date automobile insurance must meet the minimum requirement in your state
- Must be able to drive and perform quarterly visits to their members
- Prolonged periods of sitting at a desk and working on a computer
- Ability to occasionally lift objects weighing up to 15 pounds
Benefits
Comp & perks- Reasonable accommodations provided under the Americans with Disabilities Act (ADA), where medically and reasonably feasible
- Personalized health education and coaching opportunities
- Access support for exercise opportunities and nutritious food
- Up to 25% travel percentage