Our Vision is to be the best choice for healthcare in our community

Job Title: Managed Care Coordinator

Department: IPA & Accountable Care Organization (ACO)

Reports to: Manager, Florida Medical Clinic IPA

Job Summary: Assists providers, supervisors and staff members with all aspects of the Medicare Advantage plans and other value-based programs, including Accountable Care Organization. Knowledge with HEDIS quality, utilization and managing health care cost, public speaking, project management.

Minimum of 3 years' experience in a similar role preferred.

*HEDIS Quality experience preferred. *

WHAT DOES FMC HAVE TO OFFER ITS EMPLOYEES?

We offer a wide choice of compensation and benefit programs that are among the best. From competitive salaries to retirement plans. We make every effort to take care of the people who make our company great.

• Gives you an employer that you will have pride in working for
• Provides excellent training programs and opportunities for growth
• Offers Medical Benefits including:
  • Employer Contributions to HSA high deductible plan
  • Discounts at our medical facilities
  • Cigna Open Access OAPIN & OAP plans
• Supports Incentive based Wellness Programs
• Offers company sponsored Life Insurance with buy-up provisions
• Provides Dental, Vision, Long and Short Term Disability, Accident & Illness policy options
• Supports Paid Time Off and Holidays
• Gives generous 401K plan with annual 3% Employer contribution after one year of employment
• Values and appreciates its employees
• Boasts a reputation for superior health care and quality service

Essential Functions of the Position:

• Support physician practices and Care team for practices:
  • Practice Optimization Program which optimizes processes, people and technology and process improvement activities, effective use of technology
  • Provide input on POP based on physician practice interactions
  • Share meaningful data/reports and implement action plans/activity to improve performance as needed to result in a high performing practice with all team members including providers able to operate at top of license
  • Educate on quality metrics, practice performance, HCC Coding, etc. as needed for each individual practice
  • Share best practices among the group of practices/providers
  • Support Coreo training and utilization of the platform in the practice when applicable
  • Promote and facilitate clear communication within the practice and between the practice
  • Create and maintain strong relationships with physician practices
  • Create and maintain strong relationships with Care Management team in order to create a seamless connection between the practice and the patient support activities between visits
  • When applicable, assist in EMR optimization
• Identify, assess, and collaboratively work to resolve short-term and long-term issues

• Coordinates updates to Primary Care Physicians (PCP's) from Case Managers and Insurance Plan(s)
• Trains and Educate Office Staff and Providers:

• Assists the staff with work flow issues related to office processes

• Provide Center Reports during Monthly meetings.

• Monitors cost reallocation for all centers
• Prepares claims reports for all assign centers using data sources
• Provides reports (Membership, HEDIS, HCC, Quality) to offices and providers and assists with action items needed to work the reports
• Prepares reports for the Medical Director and the management team as requested

• Coordinates provider monthly meetings

• Prepares agenda for monthly meetings
• Maintains minutes and attendance sheets

• Maintains updated network information

• Maintains networks for provider practices.
• Notifies providers and staff of changes to referral requirements and insurance requirements
• Coordinates with Health insurance plans
• Attends plan-sponsored meetings and training programs

Additional Responsibilities

• Performs other incidental and related duties as required and assigned

Physical and Mental Demands:

• Normal physical ability
• Normal concentration and normal complexity of decision making
• High level of verbal and written communication skills
• Above average ability to manage multiple tasks simultaneously

Job Qualifications:

• High School graduate of GED equivalent
• Strong customer service orientation
• HEDIS and HCC knowledge preferred
• Able to organize and manage multiple task & priorities
• Computer proficiency in Word, Excel and other applications
• Excellent interpersonal and communication skills, able to communicate professionally and effectively to a diverse audience
• Self-directed and highly motivated
• Ability to travel to various locations
• Strong team player

We are an Equal Opportunity Employer and makes employment decisions without regard to race, gender, disability or protected veteran status

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