Description
Under the supervision of Regional Director of Care Management, the Utilization Management Coordinator is responsible for providing support to the Care Management team who coordinates care. This position works closely as a healthcare team member and performs complex tasks related to the overall team functions and activities identified during the initial and ongoing assessment and management of patients.
The UM Coordinator coordinates with multiple disciplines regarding inpatient notification of an admission and/or patient transfer. Performs insurance verification with focus on authorizations. Collaborates with physicians, hospital staff, insurance companies, and patient/family. Acts as liaison to facilitate and manage appropriate and timely transfers and authorizations.
Responsibilities
• Coordinating inpatient notifications and patient transfers across multiple disciplines.
• Performing insurance verification and focusing on authorizations.
• Collaborating with physicians, hospital staff, insurance companies, and patients/families to manage and facilitate appropriate and timely transfers.
Required Qualifications
5 years Hospital, clinical setting or healthcare related field
3 years Demonstrated outstanding customer service experience
3 years Clerical and computer experience
3 years Knowledge of insurance billing and managed care
Preferred Qualifications
Coursework/Training: Some college level course work or High School Diploma or GED equivalent or some college level course work preferred particularly Medical Terminology or Medical Assistance coursework.
Coursework/Training: Medical Terminology or Medical Assistant, or equivalent education/experience.
Coursework/Training: CHAA, or equivalent education/experience.
CHAA within 6 months (180 days) of hire.
3 years EPIC Case Management and ADT Patient Access.
Benefits
Our best-in‑class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
Equal Opportunity Statement
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.