Managed Care Coordinator in Rhode Island Career Overview

As a Managed Care Coordinator, you play a vital role in the healthcare system, facilitating the delivery of effective and efficient medical services. Your work focuses on coordinating care among various stakeholders, including patients, healthcare providers, insurance companies, and regulatory bodies.

Key aspects of your role include:

  • Care Coordination: You ensure that patients receive the appropriate care at the right time, overseeing the continuum of care from initial consultation to treatment and follow-up.

  • Resource Management: You are responsible for managing healthcare resources and optimizing the use of services to achieve the best outcomes for patients while adhering to budget constraints.

  • Patient Advocacy: You act as a liaison and advocate for patients, helping them navigate complex healthcare systems, understand their treatment options, and access necessary services.

  • Policy Implementation: You assist in the implementation of policies and guidelines designed to improve healthcare quality, safety, and efficiency, aligning with organizational goals and regulations.

  • Data Analysis: You analyze medical data and patient information to monitor outcomes, identify trends, and suggest improvements in care management processes.

  • Interdisciplinary Collaboration: You work closely with physicians, nurses, social workers, and other healthcare professionals to create a cohesive care plan tailored to each patient's needs.

Your involvement ensures that patients benefit from comprehensive care that is both accessible and effective, thus enhancing the overall quality of the healthcare system in Rhode Island.

Managed Care Coordinator Salary in Rhode Island

Annual Median: $122,940
Hourly Median: $59.11

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 Rhode Island

To become a Managed Care Coordinator in Rhode Island, you need to pursue specific educational qualifications and training that equip you with the necessary knowledge for the role. Consider the following degree programs:

  • Health and Medical Administrative Services: This program focuses on the administrative aspects of healthcare, including management practices, health laws, and ethical considerations.

  • Health Services Administration: A degree in this field prepares you to oversee health service organizations, focusing on the operational and financial aspects of healthcare management.

  • Health Care Administration and Management: This program provides a comprehensive understanding of healthcare systems, including policy implications, program evaluation, and resource allocation.

  • Public Health: This degree emphasizes the broader impact of health initiatives within communities. It covers topics like epidemiology, health promotion, and health policy, relevant for Managed Care Coordinators.

  • Health Policy Analysis: This specialized program centers on evaluating health policies and their implications for healthcare delivery, an essential element of coordinating managed care.

You may also benefit from internships or practical experiences during your education to apply your knowledge in real-world settings.

Best Schools to become a Managed Care Coordinator in Rhode Island 2024

#1Salt Lake County

Western Governors University

Salt Lake City, UT

In-State Tuition:$7,404
Out-of-State Tuition:$7,404
Admission Rate:N/A
Graduation Rate:49%
Total Enrollment:156,935
#2Merrimack County

Southern New Hampshire University

Manchester, NH

In-State Tuition:$15,000
Out-of-State Tuition:$15,000
Admission Rate:96%
Graduation Rate:41%
Total Enrollment:164,091
#3Tippecanoe County

Purdue University Global

West Lafayette, IN

In-State Tuition:$10,080
Out-of-State Tuition:$13,356
Admission Rate:N/A
Graduation Rate:20%
Total Enrollment:45,125
#4Hennepin County

Capella University

Minneapolis, MN

In-State Tuition:$14,328
Out-of-State Tuition:$14,328
Admission Rate:N/A
Graduation Rate:N/A
Total Enrollment:39,727
#5Baltimore City

Johns Hopkins University

Baltimore, MD

In-State Tuition:$60,480
Out-of-State Tuition:$60,480
Admission Rate:7%
Graduation Rate:94%
Total Enrollment:31,275
#6San Diego County

Ashford University

San Diego, CA

In-State Tuition:$12,240
Out-of-State Tuition:$12,240
Admission Rate:N/A
Graduation Rate:10%
Total Enrollment:34,190
Managed Care Coordinator Job Description:
  • 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 Rhode Island

  • Communication Skills: You need to convey complex information clearly to patients, healthcare providers, and insurance companies. Your ability to listen actively and respond empathetically will enhance your interactions.

  • Interpersonal Skills: Developing strong relationships with patients, healthcare professionals, and team members is essential. You should foster trust and collaboration to navigate the managed care landscape effectively.

  • Analytical Skills: You will be responsible for analyzing patient data and healthcare policies. It’s important to interpret information accurately and use it to make informed recommendations regarding patient care and resource allocation.

  • Problem-Solving Skills: As a Managed Care Coordinator, you will frequently encounter challenges that require swift resolution. You should be able to identify issues, brainstorm potential solutions, and implement effective strategies efficiently.

  • Organization and Time Management: Managing multiple cases and tasks simultaneously is part of your role. You should excel in prioritizing responsibilities and maintaining accurate records to ensure timely follow-ups and reporting.

  • Knowledge of Healthcare Regulations: Familiarity with local, state, and federal healthcare regulations is necessary for compliance and operational efficiency. You should stay updated on changes in the healthcare system to facilitate best practices in managed care.

  • Technology Proficiency: Proficient use of healthcare management software and electronic health records (EHR) is critical. You should be comfortable with various technologies that help in managing patient data and coordinate care efficiently.

  • Critical Thinking: You will often need to assess situations and make sound judgments based on evidence and data. Your ability to recognize patterns and anticipate outcomes will guide effective decision-making in patient care delivery.

  • Cultural Competence: Understanding and respecting diverse cultural backgrounds will allow you to provide patient-centered care. Awareness of cultural sensitivities can lead to better communication and health outcomes.

  • Teamwork and Collaboration: You will work alongside healthcare professionals across various disciplines. Being able to collaborate effectively and support a multidisciplinary approach to patient care is essential for success in your role.

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.

Technologies and Skills Used by Managed Care Coordinators

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 Rhode Island

The job market for Managed Care Coordinators in Rhode Island presents a robust landscape characterized by increasing demand and promising growth potential. Here are some key insights:

  • Demand for Managed Care Coordinators:
    The healthcare industry continues to evolve, with a strong emphasis on managed care as a means to provide cost-effective health services. As organizations seek to enhance patient care while controlling expenses, the need for managed care coordinators is growing. This trend is expected to continue as more health systems transition to value-based care models.

  • Growth Potential:
    Employment opportunities for Managed Care Coordinators are on the rise. The ongoing expansion of health plans, coupled with an increased focus on managing chronic conditions among the aging population, contributes to the positive outlook for this career. Opportunities may vary from direct care management roles to positions focusing on policy and program development within health organizations.

  • Geographical Hotspots:
    Several areas in Rhode Island are emerging as key locations for Managed Care Coordinator roles:

    • Providence: The state's capital is home to major healthcare institutions, including hospitals and health plans, increasing the demand for managed care professionals.
    • Warwick: With a concentration of healthcare facilities and a growing population, Warwick is becoming a notable hub for managed care positions.
    • Cranston and East Providence: These cities offer additional opportunities as they host various healthcare companies and community health programs that require managed care coordination.

  • Community Health Organizations:
    Nonprofit organizations and community health services are becoming significant employers in this field. Their focus on integrated care models often emphasizes the need for skilled managed care coordinators to navigate patient healthcare pathways.

  • Networking Opportunities:
    Engaging with professional organizations and attending industry events within Rhode Island can enhance your visibility in the job market. Connecting with local health systems and participating in healthcare seminars can open doors to new opportunities.

Overall, the job market for Managed Care Coordinators in Rhode Island is favorable, with a clear trajectory of growth and a demand for skilled professionals to meet the complexities of the healthcare landscape.

Top Related Careers to Managed Care Coordinator 2024

Patient Services Director
Healthcare Facilities Manager
Clinical Operations Manager
Public Health Administrator

Additional Resources To Help You Become a Managed Care Coordinator in Rhode Island

  • American Association of Managed Care Nurses (AAMCN)
    Explore resources, educational programs, and certifications focused on managed care nursing.
    AAMCN Website

  • National Association of Managed Care Physicians (NAMCP)
    Gain insights into managed care practice, policy, and continuous education.
    NAMCP Website

  • Centers for Medicare & Medicaid Services (CMS)
    Access official resources and guidelines related to Medicare and Medicaid managed care programs.
    CMS Website

  • Rhode Island Department of Health
    Review state-specific regulations, policies, and resources regarding managed care services.
    RI Department of Health

  • Healthcare Financial Management Association (HFMA)
    Find articles, events, and professional development opportunities related to healthcare finance, including managed care.
    HFMA Website

  • The National Center for Managed Care
    Explore a repository of reports, articles, and studies on managed care trends and practices.
    National Center for Managed Care

  • Society of Managed Care Pharmacy (SMCP)
    Stay updated with the latest developments in managed care pharmacy practices and education.
    SMCP Website

  • American College of Healthcare Executives (ACHE)
    Access a wealth of resources for healthcare management professionals, including networking opportunities and educational content.
    ACHE Website

  • Online Courses and Certifications
    Websites such as Coursera, edX, and LinkedIn Learning offer courses on managed care and healthcare administration.

  • Books and Publications
    Look for titles on managed care coordination and healthcare management in library databases or online retailers. Specific recommendations include:

    • “Managed Care: What It Is and How It Works” by Peter R. Kongstvedt.
    • “The Managed Care Handbook” by Linda K. Boswell.

Utilize these resources to enhance your knowledge, stay informed about industry trends, and expand your skills within the managed care sector in Rhode Island.

Frequently Asked Questions (FAQs) About Managed Care Coordinator in Rhode Island

  • What is a Managed Care Coordinator?
    A Managed Care Coordinator is a professional responsible for overseeing and managing the healthcare services provided to patients within a managed care setting. This role includes coordinating care plans, facilitating communication between patients and healthcare providers, and ensuring compliance with regulations and standards.

  • What qualifications do I need to become a Managed Care Coordinator in Rhode Island?
    Generally, you need a bachelor's degree in healthcare administration, nursing, social work, or a related field. Some employers may also require certifications in managed care or case management. Relevant work experience in a healthcare setting can also be beneficial.

  • What skills are important for a Managed Care Coordinator?
    Key skills include:

    • Strong communication and interpersonal skills
    • Organizational abilities
    • Problem-solving and critical thinking
    • Knowledge of healthcare regulations and policies
    • Proficiency in healthcare management software

  • What are the typical job duties of a Managed Care Coordinator?
    Duties often include:

    • Developing and implementing care plans
    • Monitoring patient progress and outcomes
    • Conducting assessments and documenting patient needs
    • Coordinating with healthcare providers and community resources
    • Ensuring proper documentation for billing and compliance

  • What is the job outlook for Managed Care Coordinators in Rhode Island?
    The job outlook for Managed Care Coordinators is positive, reflecting the growing demand for effective healthcare management as the healthcare industry continues to evolve. Increased focus on cost-effectiveness and patient-centered care drives this demand.

  • How much can I expect to earn as a Managed Care Coordinator?
    Salaries for Managed Care Coordinators in Rhode Island can vary based on experience, education, and specific employer. However, you can generally expect a salary range between $50,000 and $75,000 per year.

  • Where can I find job opportunities as a Managed Care Coordinator?
    Job opportunities can be found on various platforms, including job boards like Indeed, LinkedIn, and specialized healthcare job sites. You can also network with professionals in the field and check with local healthcare providers and insurance companies in Rhode Island.

  • What continuing education options are available for Managed Care Coordinators?
    Continuing education can include workshops, seminars, and online courses related to managed care practices, healthcare policies, and case management. Additionally, pursuing relevant certifications can enhance your knowledge and career prospects.

  • Are there professional organizations for Managed Care Coordinators?
    Yes, organizations such as the National Association of Managed Care Physicians (NAMCP) and the Case Management Society of America (CMSA) offer resources, networking opportunities, and continuing education for managed care professionals.

  • Can I work remotely as a Managed Care Coordinator?
    Some Managed Care Coordinator positions offer remote work options, particularly for companies that utilize technology for care coordination. However, the availability of remote work can vary by employer and specific job responsibilities.