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Managed Care Coordinator
Company : Post Acute Partners
Location : Amherst, NY, 14226
Job Type : Full Time
Date Posted : 4 January 2026
Salary
Pay: $18.50 - $23.07 / HourOverview
Managed Care Coordinator Overview
The Managed Care Coordinator assists and supports the LPN/RN MDS Coordinator with case management responsibilities. The candidate is the primary liaison between the SNF and the HMO Managed Care Insurance Companies. This includes all types of communication (eFax, email, scan documents, phone calls) with case managers to provide concurrent updates as requested by Insurance Companies, handles Third Party appeals, peer to peers as applicable and with clinical oversight provided by the LPN/RN MDS Coordinator. Attends team meetings at the discretion of the MDS Coordinator.
Responsibilities
Managed Care Coordinator Essential Job Fuctions
- Able to successfully interact with HMO Case Managers in a professional manner.
- Duties include scanning the documents from the EMR after the MDS Coordinator reviews.
- Participate in interdisciplinary team meetings as needed by the MDS Coordinator.
- Understands the organization's quality management program and the care coordinator’s role within that program, with compliance of all policies and procedures.
- Maintains privacy, as per policies and procedures within a secure environment of documentation and communication.
- Embraces change; maintains an open mind and is flexible and adaptable in the face of ambiguity and change.
- Utilizes electronic timekeeping system as directed.
- Arrives to work on time, regularly, and works as scheduled.
- Recognizes and follows the dress code of the facility including wearing name tag at all times.
- Follows policy and procedure regarding all electronic devices, computers, tablets, etc.
- Supports and abides by Elderwood’s Mission, Vision, and Values.
- Abides by Elderwood’s businesses code of conduct, compliance and HIPAA policies.
- Performs other duties as assigned by supervisor, management staff or Administrator.
From
Up to
Qualifications
Managed Care Coordinator Educational Requirements and Qualifications
- Minimum of High School Diploma
- 1 – 2 years of experience within the HMO Managed Care Insurance Companies
- Knowledge of Medicare and Medicaid Managed Care Policies and Utilization Review.
Managed Care Coordinator Skills and Competencies
- Demonstrated proficiency with Microsoft Office
- Bilingual English/Spanish speaking preferred
- This position requires regular interaction with residents, coworkers, visitors, and/or supervisors. In order to ensure a safe work environment for residents, coworkers, visitors, and/or supervisors of the Company, and to permit unfettered communication between the employee and those residents, coworkers, visitors, and supervisors, this position requires that the employee be able to read, write, speak, and understand the English language at an intermediate or more advanced level.
EOE Statement
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.Related Jobs
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Frequently asked questions
In healthcare settings such as Post Acute Partners, a Managed Care Coordinator's responsibilities often expand from basic case management to complex interactions with insurance providers, requiring adaptability and a deep understanding of managed care policies to effectively support patient care outcomes.
Key differentiators include proficiency in managing communications with HMO case managers, knowledge of Medicare and Medicaid policies, and bilingual capabilities, particularly English-Spanish, enhancing patient interaction and coordination within Amherst's diverse healthcare environment.
Career progression often leads to senior coordinator roles, care management supervisor positions, or specialized case management, where leadership, compliance expertise, and strategic healthcare coordination skills become increasingly vital.
Amherst's demand for skilled Managed Care Coordinators remains robust due to a growing elderly population and expanding managed care programs, making candidates with bilingual skills and managed care experience particularly sought after.
While a high school diploma and experience with managed care insurers are essential, certifications related to Medicare/Medicaid compliance or healthcare administration improve employability, especially in regions like Amherst with complex insurance landscapes.
The role offers a competitive hourly rate between $18.50 and $23.07, reflecting local market conditions and the specific demands of coordinating managed care within a skilled nursing facility environment.
Post Acute Partners provides clinical oversight and encourages collaboration with LPN/RN MDS Coordinators, empowering Managed Care Coordinators to effectively handle appeals and communicate with insurers, ensuring timely case resolutions.
Unlike hospital coordinators, this position focuses heavily on liaising with HMO managed care insurance companies within a skilled nursing framework, emphasizing document management, interdisciplinary involvement, and compliance with long-term care policies.
Yes, regular engagement with residents and healthcare teams is integral, necessitating clear communication skills and cultural sensitivity, particularly when addressing care plans and ensuring HIPAA compliance in Amherst’s community care context.
Challenges include managing timely document exchanges, understanding evolving managed care policies, and maintaining privacy standards. Preparation involves mastering electronic communication tools and staying informed about local insurance regulations.