ZipRecruiter

Log In

1

Managed Care Jobs (NOW HIRING)

Horizon Health Care Inc

Managed Care Coordinator II

$50K - $67K/yr

Acts as liaison with providers, members and Care Managers. * Perform other relevant tasks as assigned by management. Utilization Management: * Upon collection of clinical and non-clinical information ...

Nimble Solutions

Contract Specialist, Managed Care

$98K - $119K/yr

Manage and maintain accurate files for each pending and executed managed care contract; provide timely network updates to clients * Serve as the external negotiator with payers on behalf of health ...

US Radiology Specialists

Sr. Analyst, Managed Care

Hartford, CT · On-site

$88K - $117K/yr

Senior Analyst, Managed Care Responsibilities include complex data and financial analysis, financial interpretation of contract terms, contract modeling, data validation, development of reimbursement ...

Mercor

Managed Care Contract Specialist

New York, NY · Remote

$85/hr

Underpayment & Managed-care Contract Specialist Type: Contract Compensation: $85/hour Location: Remote Role Responsibilities * Identify, analyze, and recover underpayments and payment variances ...

NCH

Managed Care Contracting Analyst

Naples, FL · On-site

JOB SUMMARY The Managed Care Contracting Analyst is responsible for managing the contracting for all governmental and third party payer contracts to include provider enrollment, credentialing, data ...

Cardinal Health

Managed Care oversees the interactions that take place between payer and provider(s) to ensure optimal reimbursement including managed care contracting, enrollment, credentialing, and any other ...

New

previous page

Showing results 41-60

All JobsManaged Care Jobs

Managed Care information

See salary details

$60K

$88.7K

$124K

How much do managed care jobs pay per year?

As of Aug 7, 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.

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.

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 August 2026, with employment types broken down into 2% As Needed, 69% Full Time, 22% 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 Coordinator II

Horizon Health Care Inc

Remote

$50K - $67K/yr

Other

Medical, Dental, Vision, Retirement, PTO

Posted 4 days ago

Job description

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.
About the Role
Job Description Summary
This position supports the Clinical Operations functions and acts as a liaison between members, physicians, delegates, operational business members and member service coordinators. Responsible for providing leadership and guidance to non-clinical team and handle escalated issues/problems.
What You'll Do
  • Performs review of service requests for completeness of information, collection and transfer of non-clinical data, and acquisition of structured clinical data from physicians/patients.
  • Prepare, document and route cases in appropriate system for clinical review.
  • Initiates call backs and correspondence to members and providers to coordinate and verify benefits and courses of treatment.
  • Collect and collate information required to handle escalated phone/correspondence inquiries.
  • Upon completion of inquiry investigation/resolution, initiate call back or correspondence to physicians/members to coordinate/verify case completion.
  • Assist with on-boarding and training of newly hired Managed Care Coordinators I.
  • Acts as liaison with providers, members and Care Managers.
  • Perform other relevant tasks as assigned by management.
Utilization Management:
  • Upon collection of clinical and non-clinical information, MCC can authorize services based upon scripts or algorithms used for pre-review screening.
  • Non-Clinical staff is not responsible for conducting any UM review activities that require interpretation of clinical information.
  • Performs initial screening of precertification requests from physicians/members received via incoming calls or correspondence using established scripts and workflows under the oversight of clinical /supervisory staff.
Case Management:
  • Assists members with finding providers, resolving problems and answering questions regarding anything from how to obtain services to how to file an appeal.
  • Makes outbound calls to in order to engage members in Case Management and to complete the necessary health assessment(s) (IHS/HRA, CNA/CMNA, MLTSS Elig Survey*).
  • Distributes new case assignments to the Case Management Clinical Staff.
  • Reviews medical, dental and vision claims and address gaps in member's preventative care.
  • Educates members regarding preventive health activities and services.
  • Assists members making appointments with their PCP, specialists, and/or transportation, etc. Process PCP, demographic changes and new ID cards as requested by members.
  • Triage and distribute referrals from Member Services and incoming faxes from providers.
What You Bring
Education/Experience:
  • High School Diploma/GED required.
  • 3-5 years customer service experience.
Additional licensing, certifications, registrations:
Knowledge:
  • Requires knowledge of medical terminology.
  • Requires Good Oral and Written Communication skills.
  • Requires ability to make sound decisions under the direction of Supervisor.
  • Prefer knowledge of contracts, enrollment, billing & claims coding/processing.
  • Prefer knowledge Managed Care principles.
  • Requires knowledge of clinical standards of care, and Star measures.
  • Requires operational knowledge of health care delivery systems and health insurance industry.
  • Requires appreciation for strategic planning.
  • Requires knowledge of NCQA accreditation standards as well as state and federal laws applicable to health plan appeals and grievances.
  • Requires knowledge of CMS and state regulatory requirements.
Skills and Abilities:
  • Prefer the ability to analyze and resolve problems with minimal supervision.
  • Prefer the ability to use a personal computer and applicable software and systems.
  • Team Player, Strong Analytical, Interpersonal Skills.
Travel:
  • May require some travel.
Why Horizon?
At Horizon, you'll do meaningful work that directly improves lives-while being supported by a mission-driven organization that values expertise, collaboration, and growth. We believe that when our people thrive, our communities do too. If you are passionate about making an impact, we'd love to hear from you!
Salary Range:
$50,100 - $67,095
This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:
  • Comprehensive health benefits (Medical/Dental/Vision)
  • Retirement Plans
  • Generous PTO
  • Incentive Plans
  • Wellness Programs
  • Paid Volunteer Time Off
  • Tuition Reimbursement

Disclaimer:
Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware. This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.
Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.

Apply