Dynamic Corporate Managed Care Coordinator with extensive experience at Windsor Park Nursing Home, excelling in operational efficiency and team collaboration. Proven track record in negotiating contracts and implementing process improvements, enhancing patient care and satisfaction. Strong organizational skills and a commitment to compliance with HIPAA guidelines drive successful outcomes in managed care environments.
Overview
8
8
years of professional experience
Work History
Corporate Managed Care Coodinator
Windsor Park Nursing Home
Central Square NY
02.2022 - 08.2025
Facilitated collaboration among interdisciplinary teams to enhance patient care plans.
Directed authorization processes to improve care delivery and patient satisfaction.
Monitored compliance with regulatory standards, enhancing quality of care provided to residents.
Facilitated communication between healthcare providers and families, improving patient satisfaction rates.
Developed educational materials for staff on managed care policies and procedures, increasing operational efficiency.
Implemented quality improvement initiatives that streamlined processes and reduced administrative errors.
Trained new staff on managed care protocols, fostering a knowledgeable workforce committed to excellence in care delivery.
Ensured compliance with regulatory standards by staying current on industry best practices and incorporating them into daily operations.
Developed strong working relationships with insurance companies to streamline prior authorization processes.
Negotiated contracts with vendors that allowed more efficient use of resources without compromising quality.
Contributed significantly towards organizational goals by constantly seeking opportunities to improve processes and outcomes.
Streamlined the managed care process for better efficiency through thorough documentation and accurate recordkeeping.
Provided mentorship and guidance to junior staff members ensuring their success within the team.
Coordinated interdisciplinary team meetings to optimize patient care and ensure effective communication among providers.
Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees.
Developed and updated policies and procedures, maintaining compliance with guidelines relating to HIPAA, benefits administration and general liability.
Designed and introduced leadership development, coaching and team management model, resulting in promotion of employees into increased levels of responsibility.
Implemented successful healthcare program through professionalism, quality of care, medical teaching and patient satisfaction.
Successfully negotiated client contract renewals to create increased revenue.
Corporate Managed Care Coordinator
Sunnyside Care Center
Central Square, NY
11.2017 - 08.2025
Assisted in managing patient eligibility and authorizations for services and treatment.
Monitored compliance with managed care policies and regulations to ensure quality standards.
Developed educational materials for patients regarding health management and available resources.
Implemented process improvements to streamline care coordination workflows effectively.
Trained new staff on managed care protocols and best practices for efficient service delivery.
Streamlined the managed care process for better efficiency through thorough documentation and accurate recordkeeping.
Contributed significantly towards organizational goals by constantly seeking opportunities to improve processes and outcomes.
Negotiated contracts with vendors that allowed more efficient use of resources without compromising quality.
Facilitated smooth transitions of care between healthcare settings by working closely with discharge planners, case managers, nursing staff, and physicians.
Developed strong working relationships with insurance companies to streamline prior authorization processes.
Provided mentorship and guidance to junior staff members ensuring their success within the team.
Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees.
Led billing team operations.
Oversaw operations of accounts receivable department.
Conducted comprehensive training sessions for new hires in billing, authorization, and accounts receivable departments.