Medical Management Coordinator - PHSO

  • Adventist Health System
  • Maitland, FL, USA
  • Jan 27, 2018

Job Description

If you want to be a part of a place that provides nothing less than extraordinary compassionate care, then Adventist Health System is the place for you!

We are currently seeking qualified candidates for a Medical Management Coordinator position that will be based in our PHSO Care Management department.This position is based in Maitland, FL.

The Medical Management Coordinator is responsible for providing Medical Management support from report identification through care management assignment and distribution. This is accomplished by performing various functions, including but not limited to, running reports, reviewing reports, data entry, filing, and assisting with outcomes reporting. Adheres to AHS/Florida Hospital corporate compliance plan and to all rules and regulations of all applicable local, state and federal agencies and accrediting bodies. Attends applicable meetings to maintain up-to-date knowledge base as it relates to the Medical Management Coordinator activities. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.

Job Duties :

  • Performs and facilitates activities and functions involved in the Medical Management Coordinator job responsibilities to maintain efficient operations
  • Preparation of daily reporting and tasks to provide support to Medical Management team.
  • Distribution of daily, weekly, and monthly reports to teams and committees.
  • Preparation of bidirectional reporting, including but not limited to referrals and censuses.
  • Assists in implementation of new processes within the Medical Management department, evaluate current processes to determine appropriate use, provide assistance to Care Management staff to improve performance and productivity.
  • Maintain and update care management software program with program status details.
  • Assists and updates management on work-related issues, such as risk management, cost containment concerns, interdepartmental and/or intradepartmental concerns and medical staff issues. Assists in the preparation of cases to be reviewed by Supervisor, Director, and/or Medical Director.
  • Ensure file/records are maintained in accurate, current, organized, detailed, and confidential manner. Accurately completes all data entry and/or documentation relating to reviews and calls. Meets standards for documentation completion and accuracy as measured in regularly scheduled audits.
  • Answers telephones, conduct triage as appropriate, and route calls to appropriate staff and care managers.
  • Participates in Care Management report preparation, analysis, and/or census management, service metrics, and payor reporting. Participates in committees, teams or other work projects/duties as assigned.
  • Demonstrates regard and maintains confidentiality of all information for Case Management process in accordance with AHS policy and HIPAA regulatory requirements.

Knowledge and Skills Required:

  • High level computer skills for excel, reporting, multiple programs, and spreadsheets
  • Ability to work in a fast-paced setting
  • Excellent interpersonal skills
  • Excellent written and oral communication skills and organizational skills
  • Must demonstrate the ability to problem solve and work independently with solid judgement
  • Familiarity with HIPAA and confidentiality practices (Preferred)
  • Knowledge of medical terminology (Preferred)
  • Knowledge of crisis intervention and cultural sensitivity (Preferred)
  • Comprehensive understanding of the Care Management and Population Health purposes (Preferred)
  • Demonstrated passion for assisting Medical Management Nurse and Care Managers with assisting clients with health improvement and navigation of the health care system and programs (Preferred)

Education and Experience Requirement:

  • High School diploma or equivalent
  • 2+ years of experience of general clinical setting
  • AS/Wellness degree (Preferred)
  • 1+ years experience in managed care and/or utilization management (Preferred)
  • Experience in a human service field (Preferred)
  • Experience in a health plan or managed care organization (Preferred)

Licensure, Certification or Registration Requirements:

  • Non-licensed (MA, EMT, ETC)


  • Achieves Results: Reflects a drive to achieve and outperform, continuously looking for improvements, and accepts responsibility for actions and results
  • Builds and Shares Knowledge: Develops and shares subject matter expertise/reusable assets that can be readily applied to new tasks
  • Communication Skills: Exhibits excellent oral and written communication skills
  • Develops Self: Understands own strengths and development needs, learns from experience, and owns personal development
  • Knows the Business: Understands how the business works and can identify sources of value, efficiency, and effectiveness
  • Problem Solving: Identifies and solves problems using data collection methods, analysis, experience, and judgment
  • Subject Matter Expertise: Possesses deep knowledge and specialized skill set pertaining to the job function
  • Teams with Others: Creates an environment that values individual perspectives while driving towards common goals; assists teammates as necessary

If this position sounds like a great match for your skills set and experience, please apply online now !