Care Coordination Specialist — Managed Care

Empower Healthcare Solutions, LLC.; Little Rock (AR); On-site; USD 42,000 - 64,000; Full time

Job summary

Empower Healthcare Solutions, LLC. is seeking a Care Coordinator to manage and coordinate managed care services.

The role includes verifying eligibility, managing referrals, and obtaining authorizations for procedures and services, while delivering personalized health education to members based on treatment plans. You will verify insurance coverage, conduct utilization reviews, and collaborate with insurers and providers to ensure access to quality care.

Qualifications

• Bachelor's degree in healthcare or related field preferred.
• Knowledge of managed care principles, processes, and regulations.
• Familiarity with health insurance terminology, coverage, and benefits.

Responsibilities

• Coordinate and oversee managed care services, including referrals and authorizations.
• Verify insurance coverage and conduct utilization reviews for medical necessity.
• Provide member advocacy and assist with social determinants of health.
• Ensure compliance with laws, regulations, and contractual obligations.
• Identify opportunities for process improvement and efficiency.

Skills

Communication skills

Organizational skills

Detail-oriented

Interpersonal skills

Computer literacy

Education

Bachelor's degree in healthcare or related field

High School diploma

Tools

Health care software

Job description

Empower Healthcare Solutions, LLC. is seeking a Care Coordinator to manage and coordinate managed care services.

The role includes verifying eligibility, managing referrals, and obtaining authorizations for procedures and services, while delivering personalized health education to members based on treatment plans. You will verify insurance coverage, conduct utilization reviews, and collaborate with insurers and providers to ensure access to quality care.