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How Can I Become a Managed Care Coordinator?

Research what it takes to become a managed care coordinator. Learn about job duties, education, training requirements, and job outlook to find out if this is the career for you.

What Does a Managed Care Coordinator Do?

Managed care coordinators facilitate communications between medical facilities, insurance companies and patients. They are responsible for ensuring that medical services are authorized and that regulatory guidelines are followed. They also manage health records and make sure that all services and requests are properly documented. At some organizations, coordinators also have staff oversight responsibilities.

The table below outlines the general requirements for a career as a managed care coordinator.

Education Required Bachelor's degree, master's degree for some specialties
Education Field of Study Health services administration, public health
Key Responsibilities Authorize services, handle insurance claims, oversee patient billing, ensure Medicare and Medicaid guidelines are followed
Certification Certification with work experience required by some employers
Job Growth (2018-2028) 18% (for all medical and health services managers)*
Median Salary (2018) $49,547**

Source: *U.S. Bureau of Labor Statistics, **Payscale.com

What is a Managed Care Coordinator?

As a managed care coordinator, you will handle a variety of operational issues needed to ensure the smooth communication between a medical facility, the insurance companies the facility participates with and the patients. While reporting to upper management, you will primarily be responsible for authorizing services, handling insurance claims, overseeing patient billing and ensuring that Medicare and Medicaid guidelines are followed. You may also be asked to maintain financial and patient records and determine what services are available.

Pursue the Education and Training That Fits

Before choosing a program, you'll want to explore your options as well as the regulations for the state where you'd like to work. If you'd like to work in a specific type of facility, it's even more important you choose the right program.

Based on job listings posted in August 2012, education qualifications for a managed care coordinator can vary from simply a high school diploma combined with work experience to a master's degree. However, it is most common in this field for professionals to have a bachelor's degree in a major such as health services administration or public health. Coursework in a health services administration program may include topics such as accounting, budgeting, health information systems, hospital organization and strategic planning. A public health major may include study in general biology, health economics, human rights and health, health and environment, and health psychology.

Registered nurse (RN) certification is also often required, along with approximately 2-4 years of work experience. Working in certain specialized medical care fields, such as mental health or substance abuse, may require having a master's degree. A master's degree program typically consists of 2-3 years of study. A year of supervised experience is also generally part of the program.

Understand the Job Options

As indicated by August 2012 job listings, possible work settings for this position can range from doctor's offices, hospitals and other medical facilities to assisted living facilities, mental health units, community health centers and insurance firms. In general, the skills you need include a strong background in related medical terminology, medical coding, third-party payment systems and managed care principles. Other skills include the ability to work independently, communicate effectively and act as a liaison with relevant personnel.

Gain Experience in the Healthcare Field

Many college programs provide internships and service learning opportunities. You may want to find out if your school has campus events or relevant outreach programs. Activities like these may help you fulfill experience requirements as well as provide you with networking and other opportunities.

What Are Some Related Alternative Careers?

As an alternative, you could also consider a job as a health services manager. Rather than coordinating relations between insurance companies, medical offices and patients, you would be responsible for coordinating services within a single healthcare facility, such as a clinic or hospital. That would involve staff oversight and budgeting, along with similar managerial tasks, and you would probably need to get a bachelor's degree for the job. Alternatively, you could become a health information technician, a career that involves managing patient medical information in databases and electronic health records. For that job, you would need at least a postsecondary certificate or associate's degree.