Managed Care Coordinator II – Bilingual, Spanish Speaking

NJM Insurance Group

Managed Care Coordinator supporting Clinical Operations and liaising between members and healthcare providers. Handling inquiries, coordinating benefits, and assisting with case management.

Posted 6/18/2026full-timeRemote • New Jersey • 🇺🇸 United StatesMid-LevelSenior💰 $50,100 - $67,095 per yearWebsite

About the role

Key responsibilities & impact

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
Performs review of service requests for completeness of information
Collect and collate information required to handle escalated inquiries
Assists members with finding providers and answering questions regarding services
Makes outbound calls to engage members in Case Management

Requirements

What you’ll need

High School Diploma/GED required
Prefer 3-5 years customer service experience
Requires knowledge of medical terminology
Requires good oral and written communication skills
Prefer knowledge of contracts, enrollment, billing & claims coding/processing
Prefer knowledge of Managed Care principles

Benefits

Comp & perks

Comprehensive health benefits (Medical/Dental/Vision)
Retirement Plans
Generous PTO
Incentive Plans
Wellness Programs
Paid Volunteer Time Off
Tuition Reimbursement

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

medical terminologybilling codingclaims processingcontracts knowledgeenrollment knowledge

Soft Skills

leadershipcommunication skillsproblem-solvingcustomer serviceinterpersonal skills

Certifications

High School DiplomaGED