Utilization Management

1 week ago


Montebello, United States Cross Country Workforce Solutions Group Full time
Job DescriptionJob Description

Utilization Management (UM) Coordinator

Montebello, CA

Schedule: 8a - 5p Monday through Friday

Pay: 23- 26/hour

Summary:

This position is responsible for providing support to the Medical Management department to ensure timeliness of outpatient or inpatient referral/authorization processing per state and federal guidelines. This position performs troubleshooting when problems situations arise and coordinates with leadership.

Requirements:
1. High School Diploma or equivalent required.
2. MA or Medical Billing Certificate preferred.
3. Minimum 1 year of experience working in a medical billing environment (IPA or HMO preferred), with pre-authorizations and reimbursement
regulations pertaining to Medi-Cal, CCS and other government programs required.
4. Prior experience working in a clinic/health care specialty call center.
5. Prefer experience in utilization management processing authorization referrals.

Job Type: Temp

 

 

Company DescriptionCross Country Workforce Solutions Group (CCWSG) is a human resource, consulting and talent acquisition firm, specializing in PACE Programs, FQHCs/CHCs, and State Healthcare plans throughout the US. Our national operations center is located in Southern California.
CCWSG provides clinical and non-clinical staffing support to PACE centers across the country; we are the nation’s exclusive provider of non-medical, in-home caregivers for the elderly enrolled in PACE programs. Currently, we have over 3,000 caregivers supporting patients in their homes through PACE.
We are a part of the Cross Country Healthcare family, a market-leading workforce solutions, tech-enabled talent platform, and staffing, recruitment, and advisory firm with almost 40 years of industry experience and insight. We are a full-service partner, combining market expertise and services, including contingent staffing, consulting, human capital, management solutions, recruitment process outsourcing, vendor management, and direct hiring.Company DescriptionCross Country Workforce Solutions Group (CCWSG) is a human resource, consulting and talent acquisition firm, specializing in PACE Programs, FQHCs/CHCs, and State Healthcare plans throughout the US. Our national operations center is located in Southern California.\r
CCWSG provides clinical and non-clinical staffing support to PACE centers across the country; we are the nation’s exclusive provider of non-medical, in-home caregivers for the elderly enrolled in PACE programs. Currently, we have over 3,000 caregivers supporting patients in their homes through PACE.\r
We are a part of the Cross Country Healthcare family, a market-leading workforce solutions, tech-enabled talent platform, and staffing, recruitment, and advisory firm with almost 40 years of industry experience and insight. We are a full-service partner, combining market expertise and services, including contingent staffing, consulting, human capital, management solutions, recruitment process outsourcing, vendor management, and direct hiring.

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