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Managed Care Organization Jobs (NOW HIRING)

Humana, Inc.

Actuary - Primary Care Organization

The Actuary, Primary Care Organization (PCO) is responsible for supporting actuarial analytics ... This technology provides our team of recruiters and hiring managers with an enhanced method for ...

WakeMed

Director, Managed Care Contracting

Raleigh, NC · On-site

Directs organizations efforts at building relationships with area managed care plans. Directly manages and develops a portfolio of managed care contracts. Directs contracting strategy for hospitals ...

Direct Jobs

Director, Managed Care Contracting

Raleigh, NC · On-site

$95 - $130/hr

Directs organizational efforts at building relationships with area managed care plans. Directly manages and develops a portfolio of managed care contracts. Directs contracting strategy for hospitals ...

Ensign Services

Managed Care Resource

Orlando, FL

Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation ... Communicate effectively at all organizational levels and in situations requiring instructing ...

AdaptHealth LLC

Director, Managed Care

$150K - $190K/yr

The Director, Managed Care is responsible for strategic partnerships with Managed Care Organizations, Post-Acute providers, and Health systems, including new business and revenue development through ...

VMG HOLDINGS LLC

Director, Managed Care

Nashville, TN · On-site

Serve as the lead consultant on managed care and payer strategy engagements for hospitals, health systems, physician organizations, ambulatory surgery centers, infusion providers, and other health ...

VMG Health

Director, Managed Care

Nashville, TN · On-site

Serve as the lead consultant on managed care and payer strategy engagements for hospitals, health systems, physician organizations, ambulatory surgery centers, infusion providers, and other health ...

Ensign Services

Managed Care Resource

Pomona, CA

$110K - $130K/yr

Managed Care Resource - Los Angeles, CA Position Type: Full Time, exempt employee. Salary: $110,000 ... Communicate effectively at all organizational levels and in situations requiring instructing ...

Ensign Services

Managed Care Resource

Atlanta, GA

Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation ... Communicate effectively at all organizational levels and in situations requiring instructing ...

Ensign Services

Managed Care Resource

Long Beach, CA

$110K - $130K/yr

Managed Care Resource - Los Angeles, CA Position Type: Full Time, exempt employee. Salary: $110,000 ... Communicate effectively at all organizational levels and in situations requiring instructing ...

Washington Hospital

Director, Managed Care

Fremont, CA · On-site

$196K - $294K/yr

... organizations and levels. - Knowledge of legal terminology, understanding of governmental and legislative regulations. - Previous experience in the areas of managed care/finance/or patient accounting ...

Ensign Services, Inc.

Managed Care Resource

Pomona, CA · On-site +1

$110K - $130K/yr

Managed Care Resource - Los Angeles, CA Position Type: Full Time, exempt employee. Salary: $110,000 ... Communicate effectively at all organizational levels and in situations requiring instructing ...

Ensign Services

Managed Care Resource

Nashville, TN

Managed Care Resource - Southeast Region Position Type: Full-time, exempt employee. Compensation ... Communicate effectively at all organizational levels and in situations requiring instructing ...

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Managed Care Organization information

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$60K

$88.7K

$124K

How much do managed care organization jobs pay per year?

As of Aug 15, 2026, the average yearly pay for managed care organization 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 typical daily responsibilities for someone working within a managed care organization?

In a Managed Care Organization, daily responsibilities often include reviewing and processing insurance claims, coordinating care among healthcare providers, ensuring regulatory compliance, and managing member enrollment or benefits. Employees frequently interact with healthcare providers, members, and internal teams to resolve issues and support optimal care delivery. Data analysis for quality improvement initiatives and process refinement is also common. The role tends to be collaborative, involving cross-functional teamwork to meet organizational goals and improve patient outcomes.

What are the key skills and qualifications needed to thrive in the managed care organization position, and why are they important?

To excel in a Managed Care Organization (MCO) role, professionals typically need expertise in healthcare administration, insurance regulations, and population health management, often supported by degrees in healthcare or business and relevant certifications such as Certified Managed Care Professional (CMCP). Familiarity with claims processing systems, electronic health records (EHR), and utilization management software is essential. Strong analytical thinking, negotiation, and communication skills are crucial for collaboration and problem-solving. These competencies enable effective coordination between providers, payers, and patients to optimize care quality and cost efficiency.

What is a managed care organization?

A Managed Care Organization (MCO) job involves overseeing and coordinating healthcare services to ensure cost-effective, high-quality care for members. Roles within an MCO vary but often include case management, provider network development, claims processing, and regulatory compliance. Employees work to improve healthcare access, manage costs, and ensure that providers meet quality standards. These jobs can be found in insurance companies, government programs, and healthcare service providers.

More about Managed Care Organization jobs

What cities are hiring for Managed Care Organization jobs?

Cities with the most Managed Care Organization job openings:

What states have the most Managed Care Organization jobs?

States with the most job openings for Managed Care Organization jobs include:

What job categories do people searching Managed Care Organization jobs look for?

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Managed Care Organization jobs near you
Infographic showing various Managed Care Organization job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 70% Full Time, 21% Part Time, and 7% 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 Specialist

Otsego County

Cooperstown, NY • On-site

$42K - $50K/yr

Full-time

Posted 24 days ago

Job description

Community Services Department
EXTENDED LAST DAY FOR FILING: August 21, 2026
EOE

DISTINGUISHING FEATURES OF THE CLASS: 
The work involves managing and coordinating the delivery of behavioral health services and enrollment into managed care programs. The incumbent ensures compliance with organizational policies and payer requirements. This includes collecting, preparing and analyzing data; providing billing services, correcting errors, tracking payments, investigating and resolving appeal denied or rejected claims; monitoring the effectiveness of services; identifying opportunities for improving performance and reporting progress on performance measures. The work is performed under the direct supervision of the Behavioral Health Billing & Claims Management supervisor and general supervision by the Business Office Manager. May oversee the work of others performing related activities. Performs related duties as required.

TYPICAL WORK ACTIVITIES:  (Illustrative only)
  • Identify and ensure that all available health insurance resources are utilized to offset medical expenses incurred by clients of the agency.
  • Compile and review documents required for managed care, insurance, Medicaid, Medicare and other payer contracts.
  • Assist in internal and external insurance and billing audits by gathering requested documentation, ensuring compliance with organizational policies and payer requirements, responding to audit inquiries, and assisting with the implementation of corrective actions as needed.
  • Record and maintain accurate contract information and payer communications, appeals, authorizations, and claim activity within the electronic health record and billing systems.
  • Submit, monitor for compliance, and reconcile electronic claims to managed care organizations and third-party payers.
  • Provide support to billing services, correct errors and track payments;
  • Assist in investigating, resolving, and appealing denied or rejected claims by identifying root causes and coordinating corrective actions with clinical and billing staff.
  • Communicate with insurance representatives when required regarding claim status, payment discrepancies, prior authorizations, and reimbursement issues.
  • Review explanation of benefits (EOBs) remittance advices, and payment reports to identify billing discrepancies and initiate corrections.
  • Collaborate with clinical, registration, and billing staff to resolve documentation deficiencies that impact claim submission and payment.
  • Assist in generating and analyzing reports related to denials, authorizations, aging accounts receivable, payer trends, and reimbursement performance.
  • Compile and review data to measure performance, clinical outcomes and identify problems, gaps.
  • Assist in developing and implementing billing workflow improvements that enhance efficiency, compliance, and revenue cycle performance.
  • Perform other related duties as required.

FULL PERFORMANCE KNOWLEDGE, SKILLS, AND ABILITIES: 
Good knowledge of Medicaid/ Medicare/Managed Care and insurance policies and procedures reimbursement for behavioral health services; good knowledge of HIPPA and Corporate Compliance regulations; working knowledge of NYS OMH and OASAS regulation; working knowledge of medical terminology, insurance policies and managed care concepts; strong analytical and problem solving abilities; ability to perform electronic billing accurately; ability to collect, organize and review data; ability to communicate effectively both verbally and in writing; ability to write clear and accurate reports and maintain records as required; ability to enter, retrieve and interpret information in central computerized systems; ability to establish and maintain effective relationships with clients, staff and providers; ability to work independently; ability to manage multiple priorities and meet deadlines; ability to exercise initiative and tact.

MINIMUM QUALIFICATIONS: 
  • Graduation from high school or possession of a high school equivalency diploma; AND
  • Graduation from a regionally accredited or New York State registered college with an Associate's Degree or higher and one (1) year of full-time or its part-time equivalent experience in managed care, insurance or healthcare business operations; or
  • Three (3) years of experience as defined in (a) above.

NOTE:
Successful completion of coursework in business administration, healthcare administration or closely related field at a regionally accredited college or university, or one accredited by the New York State Board of Regents to grant degrees, may be substituted for up to one-half (1/2) of the required experience with three (3) semester credit hours of related coursework as indicated above being equivalent to three (3) months of experience.

CLASSIFICATION:  Competitive