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Utilization Management Coordinator
4 months ago
Dignity Health Medical Foundation established in 1993 is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health - one of the largest health systems in the nation - with hospitals and care centers in California Arizona and Nevada. Today Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers we provide increasing support and investment in the latest technologies finest physicians and state-of-the-art medical facilities. We strive to create purposeful work settings where staff can provide great care while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled qualities that are vital to maintaining excellence in care and service.
Responsibilities
Position Summary:
Under the direction of Utilization Management (UM) leadership, the UM Coordinator processes prior authorization with established criteria. Coordinates In-Patient and SNF process to include referral creation, formation, data entry and ensure UM notification. The UM Coordinator is responsible for referral outcome notification via letter collation and distribution to members, providers and regulatory bodies. This position keeps accurate appeals and grievance intake and outcome. The UM coordinator takes minutes and help coordinate UM meetings. This position is able to work with a variety of staff and in multiple areas as a self-starter with accuracy.
Qualifications
Minimum Qualifications:
- 3 years experience in a medical environment utilizing computer programs.
- High School Graduate
- Experience and comfort with multiple computer programs.
- Ability to work independently and as part of a group.
Preferred Qualifications:
- Working knowledge of both front and back office preferred.
- Strong understanding and experience in insurances preferred.
- Training in ICD-9 codes, provider scheduling programs, communication skills preferred.
