Ambulatory care coordinator vs managed care coordinator

Differences between ambulatory care coordinator and managed care coordinator duties and responsibilities

Ambulatory care coordinator example responsibilities.

• Manage caseload by providing care coordination to individuals with a primary intellectual/developmental disability diagnosis all of whom receive community-base waiver services.
• Initiate supportive counseling and crisis intervention for groups and individuals in children's rehabilitation hospital setting.
• Conduct NCQA audits and quality surveys for physicians.
• Assist with increasing family unity, life skills and legal entities.
• Assist members with finding placement in the ALF or SNF setting.
• Generate appropriate letters of authorization and denial according to NCQA and CMS guidelines.
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Managed care coordinator example responsibilities.

• Manage ICD-9 coding and DRG validation for high volume of claims.
• Ensure all clinical operations comply with Medicare and Medicaid guidelines and other manage care policies.
• Manage caseload by providing care coordination to individuals with a primary intellectual/developmental disability diagnosis all of whom receive community-base waiver services.
• Adhere to all state, accreditation standards and regulatory guidelines which include HIPAA guidelines and NCQA accreditation.
• Enter and approve authorizations for patients being discharge from hospitals to a sub- acute rehabilitation facility or a skil nursing facility.
• Review ICD-9 and HCPCS codes to insure proper coding used on claims.
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