Managed Care Coordinator
Horizon Blue Cross Blue Shield of NJ
- Coordinated care plans among multidisciplinary teams to enhance patient outcomes.
- Managed authorization processes for services, ensuring compliance with regulatory standards.
- Facilitated communication between providers and members to resolve inquiries efficiently.
- Analyzed claims data to identify trends and improve service delivery strategies.
- Developed educational materials for members regarding benefits and health management programs.
- Conducted outreach initiatives to increase member engagement in preventive care services.
- Implemented process improvements that streamlined workflows and reduced turnaround times.
- Mentored junior staff on best practices in managed care coordination and patient advocacy.
- Provided mentorship and guidance to junior staff members ensuring their success within the team.
- Conducted comprehensive assessments of patient needs, utilizing findings to develop tailored approaches to care management.
- Contributed significantly towards organizational goals by constantly seeking opportunities to improve processes and outcomes.
- Evaluated patient progress regularly, adjusting managed care plans as needed to reflect changes in health status or goals.