Veterans in Healthcare
Managed Care Coordinator, ObGyn
Location:
Boston, MA
Employer:
Beth Israel Deaconess Medical Center
Address:
330 Brookline Avenue, Boston, MA 02215
Employment Type:
Full-time, Day shift
Schedule:
Monday – Friday, 8:00 AM – 4:30 PM. Hybrid model – two days on-site, remaining days remote (additional on-site as needed).
Job Summary The Managed Care Coordinator supports the ObGyn Department at Beth Israel Deaconess Medical Center. The role coordinates and processes managed care referrals and authorizations for patient care services, ensuring compliance with BIDCO’s and BIDMC’s contractual rules for multiple managed care insurance payers.
Essential Responsibilities
Collaborate with referring physicians, patients, and support staff to request, obtain, record, and attach primary and/or specialty care managed care referral and authorization requests for multiple payers for a high volume of patients.
Use electronic technologies to initiate, request, and procure a high volume of referrals and authorizations for multiple managed care payers.
Educate patients about the referral process, programs offered, and services at BIDMC and affiliated CareGroup institutions; communicate the level of care and number of visits authorized to provider and/or patient.
Communicate with managed care payers to resolve referral management issues; coordinate with hospital discharge planner, registration, and pre‑certification departments as required.
Provide referral management training and oversight to department new hires; serve as a managed care resource for all unit staff.
Run daily, weekly, and monthly statistical referral management and booking reports; enter data into Excel spreadsheets.
Coordinate daily with the Referral Specialist and support staff on reporting and improve outcomes through negative indicators.
Required Qualifications
High school diploma or GED required; associate’s degree preferred.
1–3 years of related work experience.
Proficiency with computer systems, web‑based applications, and Microsoft Office (Outlook, Word, Excel, PowerPoint, Access).
Preferred Qualifications
Two years of experience in referral management or insurance managed care environment.
Basic and complex medical coding and terminology knowledge.
Primary care experience.
Competencies
Decision Making – make decisions based on instructions, standard practices and established procedures with minimal supervision.
Problem Solving – address routine or somewhat repetitive problems following clear directions and procedures.
Independence of Action – follow general instructions and procedures; work monitored by supervisor/manager.
Written Communications – communicate clearly in written English with internal and external customers.
Oral Communications – converse in English to communicate effectively with staff, patients, families and external customers.
Knowledge – demonstrate working knowledge of standard concepts, practices, procedures and policies.
Team Work – collaborate in small teams to improve operations by offering ideas and identifying issues.
Customer Service – provide high level of customer service, active listening, problem solving, remain calm in stressful situations.
Physical Nature of the Job Sedentary work; occasional exertion up to 10 pounds of force; sitting most of time; walking and standing required only occasionally.
Compensation Pay Range:
$22.50 – $30.00 per hour (base hourly wage). Actual compensation depends on seniority, education, training, experience, certifications, location and other applicable factors. May exceed base rate with shift differentials, call pay, premium pay, overtime and other practices.
Other Requirements All staff must be vaccinated against influenza (flu) as a condition of employment.
Equal Employment Opportunity Beth Israel Lahey Health, including all of its employing entities, maintains policies of equal employment opportunity and non‑discrimination in employment. If you need an accommodation for any part of the application process because of a medical condition or disability, please send an email to
kerith.dickinson@bilh.org
to let us know the nature of your request. Read our
full Equal Employment Opportunity (EEO) Policy here.
#J-18808-Ljbffr
Boston, MA
Employer:
Beth Israel Deaconess Medical Center
Address:
330 Brookline Avenue, Boston, MA 02215
Employment Type:
Full-time, Day shift
Schedule:
Monday – Friday, 8:00 AM – 4:30 PM. Hybrid model – two days on-site, remaining days remote (additional on-site as needed).
Job Summary The Managed Care Coordinator supports the ObGyn Department at Beth Israel Deaconess Medical Center. The role coordinates and processes managed care referrals and authorizations for patient care services, ensuring compliance with BIDCO’s and BIDMC’s contractual rules for multiple managed care insurance payers.
Essential Responsibilities
Collaborate with referring physicians, patients, and support staff to request, obtain, record, and attach primary and/or specialty care managed care referral and authorization requests for multiple payers for a high volume of patients.
Use electronic technologies to initiate, request, and procure a high volume of referrals and authorizations for multiple managed care payers.
Educate patients about the referral process, programs offered, and services at BIDMC and affiliated CareGroup institutions; communicate the level of care and number of visits authorized to provider and/or patient.
Communicate with managed care payers to resolve referral management issues; coordinate with hospital discharge planner, registration, and pre‑certification departments as required.
Provide referral management training and oversight to department new hires; serve as a managed care resource for all unit staff.
Run daily, weekly, and monthly statistical referral management and booking reports; enter data into Excel spreadsheets.
Coordinate daily with the Referral Specialist and support staff on reporting and improve outcomes through negative indicators.
Required Qualifications
High school diploma or GED required; associate’s degree preferred.
1–3 years of related work experience.
Proficiency with computer systems, web‑based applications, and Microsoft Office (Outlook, Word, Excel, PowerPoint, Access).
Preferred Qualifications
Two years of experience in referral management or insurance managed care environment.
Basic and complex medical coding and terminology knowledge.
Primary care experience.
Competencies
Decision Making – make decisions based on instructions, standard practices and established procedures with minimal supervision.
Problem Solving – address routine or somewhat repetitive problems following clear directions and procedures.
Independence of Action – follow general instructions and procedures; work monitored by supervisor/manager.
Written Communications – communicate clearly in written English with internal and external customers.
Oral Communications – converse in English to communicate effectively with staff, patients, families and external customers.
Knowledge – demonstrate working knowledge of standard concepts, practices, procedures and policies.
Team Work – collaborate in small teams to improve operations by offering ideas and identifying issues.
Customer Service – provide high level of customer service, active listening, problem solving, remain calm in stressful situations.
Physical Nature of the Job Sedentary work; occasional exertion up to 10 pounds of force; sitting most of time; walking and standing required only occasionally.
Compensation Pay Range:
$22.50 – $30.00 per hour (base hourly wage). Actual compensation depends on seniority, education, training, experience, certifications, location and other applicable factors. May exceed base rate with shift differentials, call pay, premium pay, overtime and other practices.
Other Requirements All staff must be vaccinated against influenza (flu) as a condition of employment.
Equal Employment Opportunity Beth Israel Lahey Health, including all of its employing entities, maintains policies of equal employment opportunity and non‑discrimination in employment. If you need an accommodation for any part of the application process because of a medical condition or disability, please send an email to
kerith.dickinson@bilh.org
to let us know the nature of your request. Read our
full Equal Employment Opportunity (EEO) Policy here.
#J-18808-Ljbffr