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Managed Care Jobs (NOW HIRING)

Ensign Services

Managed Care Resource

Orlando, FL

Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation Range: Depending on Experience. Location: Candidate must reside in the Orlando, Florida area. About ...

Washington Hospital

Director, Managed Care

Fremont, CA

$196K - $294K/yr

Director, Managed Care Contracting Position Summary and profitability by providing contracting expertise to existing and new contractual relationships; and providing subject matter expertise ...

Ensign Services, Inc.

Managed Care Resource

Orlando, FL · On-site +1

Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation Range: Depending on Experience. Location: Candidate must reside in the Orlando, Florida area. About ...

Gentiva

Director Managed Care

Atlanta, GA · On-site

Overview: Fully Remote Role with 10 to 30% travel The Director, Managed Care is a key operational leader within Gentiva's Managed Care team, reporting to the AVP, Managed Care. This role is ...

WakeMed

Director, Managed Care Contracting

Raleigh, NC · On-site

Overview The Director, Managed Care Contracting is responsible for utilizing business and industry expertise, accepts responsibility for all activities in the Managed Care department applying to and ...

InstantServe LLC

Managed Care Specialist

Nashville, TN · On-site

Position Overview Our client is seeking to hire a Managed Care Specialist for a hybrid role. Candidates will work both remotely and onsite based on business and team needs. Extensive training will be ...

Pacs

$110K - $150K/yr

Analyzes existing managed care agreements to determine if rates need to be renegotiated, or if contract needs to be terminated. Provide consultation with operations to determine desired next steps.

Healthcare Nursing Center

Managed Care Biller

Charleston, IL · On-site

$16.75 - $21.50/hr

Managed Care Biller Location: Charleston, Illinois (on-site) Reports To: Billing Director About the Opportunity The Managed Care Biller is responsible for the accurate and timely billing of all ...

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$60K

$88.7K

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How much do managed care jobs pay per year?

As of Jul 16, 2026, the average yearly pay for managed care in the United States is $88,749.00, according to ZipRecruiter salary data. Most workers in this role earn between $72,500.00 and $103,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in Managed Care, and why are they important?

To excel in Managed Care, you need strong analytical abilities, knowledge of healthcare regulations, and typically a degree in healthcare administration, public health, or a related field. Familiarity with claims processing systems, data analytics tools, and industry-specific software such as Epic or Meditech is often required. Excellent communication, negotiation, and problem-solving skills help professionals build relationships with providers and navigate complex patient needs. These competencies are crucial for optimizing patient outcomes, controlling costs, and ensuring compliance within the evolving healthcare landscape.

What is managed care?

Managed care refers to a healthcare delivery system designed to manage cost, utilization, and quality. It involves a network of providers and organizations that coordinate patient care to improve health outcomes while controlling expenses. Managed care plans often require members to choose healthcare providers from a specific network and may require pre-authorization for certain services. Common types of managed care include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Point of Service (POS) plans.

What are the most common challenges faced by professionals working in Managed Care roles?

Professionals in Managed Care often navigate complex regulatory requirements while balancing cost efficiency and quality patient care. One common challenge is coordinating between healthcare providers, insurance companies, and patients to ensure effective coverage and access to services. Additionally, staying updated on frequently changing policies and negotiating contracts can require strong analytical and communication skills. Collaboration with interdisciplinary teams is essential, and adaptability is key to managing evolving healthcare trends and payer guidelines.

Is being a MOA a good entry level job?

Medical Office Assistants (MOAs) often start in entry-level positions, providing administrative and clinical support in healthcare settings. The role typically requires basic medical office skills, such as scheduling, patient communication, and familiarity with electronic health records, making it accessible for those seeking an initial healthcare job. It can serve as a stepping stone to more advanced healthcare roles with experience and additional training.

What is a managed care job?

A managed care job involves coordinating healthcare services to ensure cost-effective and quality patient care, often within insurance companies, health plans, or healthcare organizations. Roles may include case managers, utilization reviewers, or health plan administrators, requiring knowledge of healthcare policies, insurance processes, and sometimes certifications like CCM or CHC.

What is the difference between Managed Care vs Health Insurance Coordinator?

AspectManaged CareHealth Insurance Coordinator
CredentialsTypically requires a degree in healthcare administration, nursing, or related fieldsOften requires knowledge of insurance policies, customer service, and sometimes certifications like CPC or HIPAA training
Work EnvironmentHospitals, insurance companies, healthcare networksInsurance companies, healthcare offices, clinics
Employer & Industry UsageHealthcare providers, insurance plans, government programsInsurance providers, healthcare organizations
Common Search & Comparison IntentUnderstanding managed care plans, healthcare managementManaging insurance claims, policy details

Managed Care professionals focus on coordinating healthcare services within managed care plans, emphasizing cost control and quality. Health Insurance Coordinators handle insurance policies, claims, and customer support. While both roles involve insurance, managed care is broader, often involving healthcare management, whereas insurance coordinators focus on policy administration.

What is the highest paying job in healthcare management?

The highest paying roles in healthcare management are often executive positions such as Chief Executive Officer (CEO), Chief Operating Officer (COO), or Chief Financial Officer (CFO) of healthcare organizations. These roles typically require extensive experience, advanced degrees, and strong leadership skills, with salaries often exceeding six figures annually.

What does a managed care department do?

A managed care department oversees healthcare plans that coordinate and control patient care to reduce costs and improve quality. Staff in this department develop provider networks, manage claims, and ensure compliance with regulations, often using data analysis and healthcare management tools.
More about Managed Care jobs
What cities are hiring for Managed Care jobs? Cities with the most Managed Care job openings:
What are the most commonly searched types of Managed Care jobs? The most popular types of Managed Care jobs are:
What states have the most Managed Care jobs? States with the most job openings for Managed Care jobs include:
What job categories do people searching Managed Care jobs look for? The top searched job categories for Managed Care jobs are:
Managed Care jobs near you
Infographic showing various Managed Care job openings in the United States as of July 2026, with employment types broken down into 2% As Needed, 70% Full Time, 22% Part Time, and 6% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $88,749 per year, or $42.7 per hour.
Managed Care Compliance Specialist - Managed Care

Managed Care Compliance Specialist - Managed Care

Cedars Sinai

Beverly Hills, CA

Other

Re-posted 9 days ago

Cedars-Sinai rating

8.6

Company rating: 8.6 out of 10

Based on 130 frontline employees who took The Breakroom Quiz

37th of 1,020 rated hospitals

Job description

The Managed Care Compliance Specialist is responsible for assisting with the implementation of the internal auditing and monitoring program within the Managed Care department by ensuring compliance with applicable rules and regulations including but not limited to AB1455 and Medicare Claims Processing Guidelines. This position is responsible for maintaining routine auditing functions and providing feedback on departmental activities, to assure compliance with all health plan and regulatory agencies, including CMS, DMHC, and DHCS.

Duties and Responsibilities:
  • Ensures all services provided to Commercial, Medicare and Medi-cal managed care members are in compliance with program regulations, insurance regulations, and regulatory requirements.
  • Maintains and tracks laws and regulations, contract documentations, amendments, and various compliance measures pertaining to Commercial, Medicare and Medi-cal managed care.
  • Develops policies, procedures, and processes to align with federal program regulations and any applicable state regulations pertaining to Commercial, Medicare and Medi-Cal managed care.
  • Provides mentorship to various departments regarding compliance issues and implementation of new compliance requirements with respect to regulatory and contract language for Commercial, Medicare and Medi-Cal managed care.
  • Acts as a liaison with health plans and current CSHS departments to ensure both health plan regulations and CSHS policies are met.
  • Coordinates and act as primary contact for all health plans audits, including leading all aspects of the review for performance management and accurate coding.
  • Develops and supervise compliance with corrective action plans as a result of post-health plan audits and regulatory audits.
  • Provides required Compliance and FWA trainings for existing, new employees and non-employees, as the need arises.
  • Educates CSHS employees on company policies and procedures regarding access to care, the grievance and appeals process, the eligibility process, etc.
  • Remains updated on all member and provider policy changes made by the health plan and/or the State.
  • Acts as subject matter expert on health care laws/regulations as a compliance resource to CSHS and affiliates, including contracted and employed physician practices.
  • Aggregates, analyze, and report audit results, identify error trends and root causes, and make recommendations for performance improvements.
Cedars-Sinai is a leader in providing high-quality healthcare encompassing primary care, specialized medicine and research. Since 1902, Cedars-Sinai has evolved to meet the needs of one of the most diverse regions in the nation, setting standards in quality and innovative patient care, research, teaching and community service. Today, Cedars- Sinai is known for its national leadership in transforming healthcare for the benefit of patients. Cedars-Sinai impacts the future of healthcare by developing new approaches to treatment and educating tomorrow's health professionals. Additionally, Cedars-Sinai demonstrates a commitment to the community through programs that improve the health of its most vulnerable residents.With a growing number of primary urgent and specialty care locations across Southern California, Cedars-Sinai's medical network serves people near where they live. Delivering coordinated, compassionate healthcare you can join our network of clinicians and physicians to improve the healthcare people throughout Los Angeles and beyond.Education:

High school diploma/GED required. Bachelor's degree in Healthcare or related field preferred.

Experience:

Five (5) years of compliance experience, preferably in a healthcare environment, required. Two (2) years of Medi-Cal, Medicare or Commercial Managed Care experience preferred.

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