Managed Care Coordinator I

Job description

Description About CLS Health: CLS Health is a growing healthcare system in Houston, Texas that is taking a different approach to healthcare. We are a physician-led healthcare group that focuses on providing patients with holistic, multispecialty care. We're a dynamic team on a mission to provide better healthcare options for Houstonians! Job Overview : The Managed Care Coordinator I is responsible for coordinating and ensuring the delivery of high-quality, cost-effective healthcare services to members. This role involves working closely with healthcare providers, patients, and insurance companies to facilitate care, manage resources, and support the healthcare team in achieving optimal patient outcomes. Responsibilities: Benefits: - Ensure all clinical operations comply with Medicare and Medicaid guidelines and other manage care policies. - Adhere to all state, accreditation standards and regulatory guidelines which include HIPAA guidelines and NCQA accreditation. - Conduct outgoing calls to patients to arrange appointments. - Make outgoing calls to pharmacies to confirm each patient’s medication adherence. - Prepare charts for providers, highlighting managed care directives that n...