Managed Care Coordinator in North Carolina Career Overview
As a Managed Care Coordinator, you play a vital role in navigating the complexities of healthcare delivery systems. Your primary focus revolves around coordinating care for patients in a managed care environment, ensuring they receive appropriate and timely services while adhering to the parameters set by insurance plans.
Key responsibilities in this role include:
Assessment and Planning: You evaluate the needs of patients, develop individualized care plans, and ensure that services provided align with their specific medical requirements.
Collaboration: You work closely with healthcare providers, insurance companies, and patients to facilitate communication, streamline processes, and promote a cohesive approach to care.
Resource Management: You are responsible for managing healthcare resources efficiently. This includes authorizing services, managing referrals, and ensuring that care is delivered within the constraints of the insurance policy.
Education and Support: You provide guidance to patients and their families regarding the managed care process, helping them understand their benefits, treatment options, and any potential out-of-pocket costs.
Quality Improvement: You monitor the quality of care provided, looking for areas of improvement to enhance patient outcomes and satisfaction while ensuring compliance with regulatory standards and organizational policies.
In the evolving landscape of healthcare, your role as a Managed Care Coordinator is increasingly important. You contribute to the effectiveness of healthcare delivery by ensuring that patients navigate the system smoothly and receive the care they need, ultimately improving health outcomes and optimizing resources.
Managed Care Coordinator Salary in North Carolina
Data sourced from Career One Stop, provided by the BLS Occupational Employment and Wage Statistics wage estimates.
Required Education To Become a Managed Care Coordinator in North Carolina
To become a Managed Care Coordinator in North Carolina, you typically need to complete specific educational programs. Here are the degree options that align with the requirements for this role:
Health and Medical Administrative Services
- This program provides foundational knowledge in healthcare administration, focusing on the management of healthcare facilities and services.
Health Services Administration
- This degree equips you with the skills for overseeing and managing healthcare systems, preparing you for the complexities of managed care.
Health Care Administration and Management
- This program emphasizes the business and operational aspects of healthcare, training you to handle administrative responsibilities in a managed care environment.
Public Health
- A degree in public health focuses on community health initiatives and policies, essential for understanding the broader context of healthcare delivery and managed care systems.
Health Policy Analysis
- This program deals with the evaluation and formulation of health policies, providing insight into policy creation and its implications for healthcare management.
In addition to obtaining a degree, many positions may also require certifications or further training in specific healthcare management techniques or software.
Best Schools to become a Managed Care Coordinator in North Carolina 2024
Western Governors University
Southern New Hampshire University
Purdue University Global
Capella University
Johns Hopkins University
Ashford University
- Plan, direct, or coordinate medical and health services in hospitals, clinics, managed care organizations, public health agencies, or similar organizations.
Managed Care Coordinator Required Skills and Competencies in North Carolina
Communication Skills: You must be able to communicate clearly and effectively with patients, healthcare providers, and insurance companies. This includes both verbal and written communication.
Interpersonal Skills: Building strong relationships is essential. You need to be approachable and empathetic, helping to foster trust with patients while maintaining professional interactions with team members and stakeholders.
Organizational Skills: You should excel in managing multiple tasks and priorities. This includes scheduling appointments, managing documents, and ensuring compliance with regulations.
Analytical Skills: You need to analyze data related to patient care, costs, and outcomes. This capability helps in evaluating treatment plans and identifying areas for improvement.
Problem-Solving Skills: You should have the ability to identify issues quickly and develop effective solutions to complex challenges faced by patients and healthcare providers.
Knowledge of Healthcare Regulations: A strong understanding of the rules and regulations governing managed care, including Medicare and Medicaid, is essential for ensuring compliance and best practices.
Technical Proficiency: Familiarity with electronic health records (EHR) and healthcare management software is important. This skill enhances your ability to manage patient information and care coordination.
Attention to Detail: Precision is critical in this role. You should be able to meticulously review documents, treatment plans, and claims to prevent errors.
Teamwork Orientation: Collaboration with various healthcare professionals is essential. You should be able to work effectively within a multidisciplinary team to achieve common goals for patient care.
Cultural Competence: You must understand and respect diverse patient backgrounds and beliefs, which is vital for delivering equitable and effective care.
Time Management Skills: The ability to prioritize tasks efficiently and meet deadlines is necessary for managing workloads and ensuring timely patient care.
Adaptability: You should be open to change and capable of adjusting your approaches in response to evolving healthcare practices and patient needs.
Job Duties for Managed Care Coordinators
Develop and maintain computerized record management systems to store and process data, such as personnel activities and information, and to produce reports.
Direct, supervise and evaluate work activities of medical, nursing, technical, clerical, service, maintenance, and other personnel.
Plan, implement, and administer programs and services in a health care or medical facility, including personnel administration, training, and coordination of medical, nursing and physical plant staff.
Analytical or scientific software
- IBM SPSS Statistics
- SAS
Data base user interface and query software
- Blackboard software
- Yardi software
Medical software
- Epic Systems
- eClinicalWorks EHR software
Basic Skills
- Talking to others
- Thinking about the pros and cons of different ways to solve a problem
Problem Solving
- Noticing a problem and figuring out the best way to solve it
Social
- Bringing people together to solve differences
- Understanding people's reactions
Job Market and Opportunities for Managed Care Coordinator in North Carolina
The job market for Managed Care Coordinators in North Carolina is currently robust, reflecting the growing demand for healthcare professionals who can effectively manage patient care and coordinate services. Here are some key insights into the market trends and opportunities available:
Demand for Managed Care Coordinators: There is a rising need for Managed Care Coordinators due to an increasing focus on value-based care and the ongoing shift towards managed care systems. Hospitals, health insurance companies, and healthcare providers are actively seeking professionals to improve care delivery and patient outcomes.
Growth Potential: The managed care sector is expected to grow significantly in the coming years. As healthcare becomes more complex with the integration of new technologies and regulatory changes, the role of Managed Care Coordinators will become even more vital for ensuring efficient operations and patient satisfaction. The U.S. Bureau of Labor Statistics projects strong job growth in this field, driven by an aging population and an increasing prevalence of chronic diseases.
Geographical Hotspots: In North Carolina, several regions are emerging as key areas for Managed Care Coordinator opportunities.
- Charlotte: As one of the largest metropolitan areas in the state, Charlotte is home to numerous healthcare facilities and insurance companies, making it a prime location for job opportunities.
- Raleigh-Durham: This region is known for its concentration of research and educational institutions, alongside major healthcare providers. The presence of organizations like Duke University Health System contributes to the demand for Managed Care Coordinators.
- Greensboro: With a growing population and expanding healthcare infrastructure, Greensboro offers increasing roles for Managed Care Coordinators in various healthcare settings.
- Wilmington: Coastal areas like Wilmington are also experiencing growth in healthcare services, providing another venue for those seeking positions in managed care.
Industry Diversity: The managed care sector in North Carolina encompasses a variety of settings, including hospitals, outpatient services, insurance companies, and home health services. This diversity allows for a range of opportunities tailored to different interests and expertise.
Considering these factors, you will find the current landscape for Managed Care Coordinators in North Carolina to be promising, with numerous opportunities for professional growth and development in a dynamic healthcare environment.
Top Related Careers to Managed Care Coordinator 2024
Additional Resources To Help You Become a Managed Care Coordinator in North Carolina
North Carolina Department of Health and Human Services (NCDHHS)
Website: NCDHHS
This site provides information on health care policies, programs, and resources in North Carolina. It is a valuable resource for understanding managed care in the state.North Carolina Medical Society (NCMS)
Website: NCMS
The NCMS offers resources for health care professionals, including updates on managed care practices, policy changes, and networking opportunities.Centers for Medicare & Medicaid Services (CMS)
Website: CMS
This federal agency provides guidance and regulations surrounding Medicare and Medicaid Managed Care. Review program details and updates that affect North Carolina.American Academy of Managed Care Pharmacy (AMCP)
Website: AMCP
A professional association that focuses on managed care pharmacy, offering educational resources, policy information, and links to continuing education opportunities.Academy of Managed Care Pharmacy (AMCP) Managed Care Pharmacy Course
Course Information: AMCP Course
This online course provides foundational knowledge in managed care pharmacy and practice management, ideal for coordinators.National Association of Managed Care Physicians (NAMCP)
Website: NAMCP
This organization provides education, advocacy, and networking for physicians in managed care, offering various resources for ongoing professional development.Healthcare Financial Management Association (HFMA)
Website: HFMA
HFMA provides resources on health care finance, reimbursement, and managed care operations, facilitating better financial management in health care settings.Association for Community Affiliated Plans (ACAP)
Website: ACAP
This association focuses on safety-net health plans, providing resources and best practices for managed care within underserved communities.Society for Healthcare Strategy & Market Development (SHSMD)
Website: SHSMD
SHSMD offers resources related to healthcare strategy and marketing, essential for Managed Care Coordinators involved in community outreach and patient engagement.Local Community Colleges and Universities
Many institutions in North Carolina offer courses in health care administration or management. Check their catalogs for programs relevant to managed care coordination.LinkedIn Groups
Joining LinkedIn groups focused on managed care can provide networking opportunities, industry insights, and discussions with peers in the field.Books and Journals
Consider reading titles such as "Managed Care: What It Is and How It Works" by Peter R. Kongstvedt for foundational knowledge and best practices. Access industry journals like the "Journal of Managed Care & Pharmacy" for current research and trends.
Utilizing these resources can significantly enhance your understanding and preparedness for a successful career as a Managed Care Coordinator in North Carolina.
Frequently Asked Questions (FAQs) About Managed Care Coordinator in North Carolina
What is a Managed Care Coordinator?
A Managed Care Coordinator oversees patient care within managed care systems, working with healthcare providers and insurance companies to ensure that patients receive appropriate services while adhering to cost constraints.What are the primary responsibilities of a Managed Care Coordinator?
Your responsibilities typically include coordinating patient care, managing authorizations for services, liaising between healthcare providers and insurance companies, maintaining patient records, and analyzing care management strategies.What education is required to become a Managed Care Coordinator?
Most positions require at least a bachelor’s degree in healthcare administration, nursing, or a related field. Some roles may prefer or require a master’s degree or specialized certifications.Is prior experience needed to work as a Managed Care Coordinator?
Many employers prefer candidates with prior experience in healthcare settings, particularly in case management, nursing, or managed care environments. Internships or volunteer work can also be beneficial.What skills are essential for a Managed Care Coordinator?
Key skills include strong communication and interpersonal abilities, analytical skills, attention to detail, problem-solving capabilities, and knowledge of healthcare regulations and insurance processes.Are there certification options for Managed Care Coordinators?
Yes, certifications such as the Certified Managed Care Professional (CMCP) or Certified Case Manager (CCM) can enhance your qualifications and may be preferred by employers.What is the job outlook for Managed Care Coordinators in North Carolina?
The demand for Managed Care Coordinators is expected to grow as healthcare becomes more complex and as the need for cost-effective care increases, particularly within managed care organizations.What is the typical salary for a Managed Care Coordinator in North Carolina?
Salaries can vary based on experience, location, and employer, but as of 2023, the average salary ranges between $48,000 and $75,000 per year.What work settings do Managed Care Coordinators typically operate in?
You can find Managed Care Coordinators working in hospitals, health insurance companies, outpatient care centers, and private practices.What advancements are available for a Managed Care Coordinator?
With experience, you may advance to roles such as Managed Care Director, Health Services Manager, or pursue specialty areas in case management or health policy. Continuing education and certifications can aid in career advancement.