Looking for a Career - Managed Care PossibilitiesNew, seasoned pro, permanent, temporary... oh the possibilities! Managed Care markets offer career opportunities for all levels of employment whether your resume includes high school grades or accolades from Harvard. All skills are needed ranging from administrative work to a Medical Director reviewing a member's chart.  

Some specialty departments within a Managed Care Organization (MCO) are Legal, Contracting, Marketing, Member Services, Customer Services, Claims, Provider Services, Quality Management, Analytics, Finance, Sales… There are more but that gives you an idea of the complexity of the business structure. Phones must be answered, memos must be typed, meetings must be arranged, finances must be reviewed, claims must be paid, marketing must be organized, quality must be assessed... Need I go on?

According to the Center for Medicare and Medicaid Services (CMS), in 2016, there were approximately 56 million Medicaid recipients and 17 million Medicare recipients enrolled in managed care. 73 million people. In 2014, Kaiser Family Foundation reported Medicaid healthcare costs in excess of $496 billion dollars and Medicare healthcare expenses topped $618 billion - this equates to a three trillion dollar industry.  

Medicaid vs. Medicare

Medicaid is an assistance program available for qualified people based on income and financial need. There is no monthly premium and usually no cost for covered healthcare expenses.

Medicare serves people over 65, disabled people and dialysis patients. It is not based on income or financial need. There is often a monthly payment, deductibles and co-payments.

Just imagine how many people are required to keep a three trillion dollar industry running. Then all the sudden claims don't get paid. Major meltdown. Possible irreparable damage to the company reputation.

Required Skills

It is imperative to have highly skilled, motivated, well-trained employees with a clear understanding of their role and importance to the overall mission of the company.

Bilingual? BONUS. The number of people in the US who speak a language other than English has more than doubled since 1980. In 2011, the US Census Bureau reported: 

  • Spanish speaking - 37.5 million – up 210% since 1980
  • Chinese speaking – 2.9 million – up 290% since 1980
  • Korean speaking – 1.5 million – up 400% since 1980
  • Vietnamese speaking – 1.4 million. This is the fastest growing language in the US with an increase of over 500% since 1980. 

Even though these individuals are often bilingual, many are not. It is imperative that healthcare communications be presented in a way easily understood by these populations. Many managed care organizations are hiring bilingual employees and/or utilizing companies specializing in interpreter services.

There are unbelievable numbers of possible career opportunities in managed care. United Health Care has over 200,000 employees, Anthem 53,000 - that is over 250,000 just in these two. I won't venture too far into salary ranges but I image there is a wide range there between CEO and entry level administrative.  

Helpful Resources

A recent internet surf lead me to a site ExploreHealthCareers.org for the healthcare portion of managed care opportunities. There is great information available here for all healthcare levels. More specific to managed care, I found Managedcarebiz.org – well worth a review. 

Also you should visit glassdoor.com or Salary.com to review salaries for positions you are considering. If you are just starting on the road to a career, talk with your academic counselor. If you are interested in talking with a particular company about possible employment - don't be afraid to call their Human Resources Department. 

HOW CAN WE FURTHER DEVELOP A MORE DIVERSE ENVIRONMENT FOR OUR PATIENTS?
Share your thoughts down in the comments!