Current jobs related to Coordinator - Utilization Management Outpatient - Rancho Cucamonga - Inland Empire Health Plan
-
Outpatient Utilization Management Coordinator
2 weeks ago
Rancho Cucamonga, California, United States Alura Workforce Solutions Full timePosition Outpatient Utilization Management Coordinator Description Under the supervision of the Utilization Management Outpatient Manager and Supervisor, the Outpatient Utilization Management Coordinator plays a crucial role in the efficient processing of authorization requests. This dynamic position necessitates prompt verification of eligibility and the...
-
Outpatient Utilization Management Coordinator
2 weeks ago
Rancho Cucamonga, California, United States Alura Workforce Solutions Full timePosition Outpatient Utilization Management Coordinator Description Under the supervision of the Utilization Management Outpatient Manager and Supervisor, the Outpatient Utilization Management Coordinator plays a crucial role in the efficient processing of authorization requests. This dynamic position necessitates prompt verification of eligibility and the...
-
Outpatient Utilization Management Coordinator
2 weeks ago
Rancho Cucamonga, California, United States Alura Workforce Solutions Full timePosition Outpatient Utilization Management Coordinator Overview Under the supervision of the Utilization Management Outpatient Manager and Supervisor, the Outpatient Utilization Management Coordinator plays a critical role in the efficient processing of authorization requests. This dynamic position necessitates prompt verification of eligibility and the...
-
Utilization Management Outpatient Coordinator
4 weeks ago
Rancho Cucamonga, United States Alura Workforce Solutions Full timePosition Coordinator- Utilization Management Outpatient Description Under the general direction of the UM Outpatient Manager and Supervisor, the Outpatient UM Coordinator, is a high paced position that requires timely processing of authorization requests, verifying eligibility and obtaining additional information as requested by Medical Management or...
-
Rancho Cucamonga, California, United States Alura Workforce Solutions Full timeJob SummaryWe are seeking a highly organized and detail-oriented Outpatient Utilization Management Coordinator to join our team at Alura Workforce Solutions. As a key member of our Utilization Management Department, you will play a critical role in ensuring timely and accurate processing of authorization requests, verifying eligibility, and obtaining...
-
Rancho Cucamonga, United States Alura Workforce Solutions Full timePositionCoordinator- Utilization Management OutpatientDescriptionUnder the general direction of the UM Outpatient Manager and Supervisor, the Outpatient UM Coordinator, is a high paced position that requires timely processing of authorization requests, verifying eligibility and obtaining additional information as requested by Medical Management or...
-
Temporary Coordinator
4 weeks ago
Rancho Cucamonga, United States Experis Full timeJob Title: Utilization Management Outpatient Duration: 6 months Location: Rancho Cucamonga, CA (Hybrid, Twice in a month) Pay rate: $23.98/hr.We are looking for an Utilization Management Outpatient to join one of our Fortune 500 Healthcare clients. Key Responsibilities: Responsible for monitoring the Right Fax Server. Ensuring all referrals are processed in...
-
Temporary Coordinator
4 weeks ago
Rancho Cucamonga, United States Manpower Group Inc. Full timeJob Title: Utilization Management Outpatient Duration: 6 months Location: Rancho Cucamonga, CA (Hybrid, Twice in a month) Pay rate: $23.98/hr. We are looking for an Utilization Management Outpatient to join one of our Fortune 500 Healthcare clients. Key Responsibilities: Responsible for monitoring the Right Fax Server. Ensuring all referrals are processed...
-
Utilization Management Nurse LVN
2 weeks ago
Rancho Cucamonga, California, United States Alura Workforce Solutions Full timePosition Title: Utilization Management Nurse LVNPosition Type: TelecommuteSchedule: Monday to Friday, 8:00 AM – 5:00 PMJOB SUMMARYThe Utilization Management Nurse LVN plays a crucial role in the healthcare delivery system by:1. Collecting clinical documentation to support the Registered Nurse and Medical Director in making informed decisions regarding...
-
Clinical Utilization Manager
14 hours ago
Rancho Cucamonga, California, United States Alura Workforce Solutions Full timeJob SummaryWe are seeking a skilled Vocational Nurse to join our team as a Clinical Utilization Manager in our Outpatient UM department. As a key member of our team, you will play a critical role in ensuring the efficient and effective management of outpatient services and care.Key ResponsibilitiesGather and review clinical documentation to support the R.N....
-
Utilization Management Nurse LVN
2 weeks ago
Rancho Cucamonga, California, United States Alura Workforce Solutions Full timePosition TitleUtilization Management Nurse LVNPosition Type: TelecommuteSchedule: M-F, 8:00 am – 5:00 pmJOB SUMMARYAs a Utilization Management Nurse LVN, you will play a crucial role in the healthcare delivery process by:1. Collecting and reviewing clinical documentation to support the R.N. Letter Review Nurse and Medical Director in evaluating the...
-
Utilization Management Nurse LVN
2 weeks ago
Rancho Cucamonga, California, United States Alura Workforce Solutions Full timePosition Title: Utilization Management Nurse LVNPosition Type: TelecommuteSchedule: Monday to Friday, 8:00 AM – 5:00 PMJOB SUMMARYThe Utilization Management Nurse LVN plays a crucial role in the healthcare delivery system by ensuring the appropriateness of outpatient services. The responsibilities include:1. Collecting clinical documentation to support the...
-
Outpatient Referral Specialist
2 weeks ago
Rancho Cucamonga, California, United States HealthCare Support Full timeJob OverviewPosition: Outpatient Referral Specialist - Hybrid RoleHealthCare Support is currently seeking a dedicated Outpatient Referral Specialist to join our team within a prominent not-for-profit health plan.Key Responsibilities:Assist in the efficient processing of authorization requests under the guidance of the Utilization Management (UM) team.Verify...
-
Construction Project Coordinator
2 weeks ago
Rancho Cucamonga, California, United States Food Management Search Full timeCompany Overview:Company is a premier heavy civil construction firm, generating over $600 million annually. Established in 1988, we have consistently expanded our operations and capabilities over the years.Our Expertise Includes:We focus on a wide range of services including:- Underground Utilities (Gas, Water, Sewer, Fiber Optic, Electrical)- Foundations,...
-
Medical Biller Coordinator
2 weeks ago
Rancho Cucamonga, California, United States AppleOne Full timeJob OverviewWe are seeking a highly organized and detail-oriented Medical Biller Coordinator to join our team at AppleOne. As a key member of our Utilization Management Department, you will play a crucial role in ensuring the smooth operation of our referral processing and data accuracy initiatives.Key ResponsibilitiesReferral Processing: Monitor and manage...
-
Medical Biller Coordinator
2 weeks ago
Rancho Cucamonga, California, United States AppleOne Full timeJob OverviewWe are seeking a highly organized and detail-oriented Medical Biller Coordinator to join our team at AppleOne. As a key member of our Utilization Management Department, you will play a crucial role in ensuring the smooth operation of our referral processing and data accuracy initiatives.Key ResponsibilitiesReferral Processing: Monitor and manage...
-
Marketing Coordinator
3 weeks ago
Rancho Cucamonga, California, United States Instep Management Group Full timePosition OverviewThe Marketing Coordinator role is an essential contributor within the marketing division. This position is designed for individuals at the beginning of their marketing careers, with ample opportunities for advancement within the organization. The training program encompasses a thorough introduction to fundamental marketing principles, direct...
-
Licensed Vocational Nurse
7 days ago
Rancho Cucamonga, California, United States Kaiser Permanente Full timeJob SummaryWe are seeking a skilled Licensed Vocational Nurse (LVN) to join our team at Kaiser Permanente. As an LVN, you will play a vital role in providing high-quality patient care and contributing to the success of our outpatient care services.Key ResponsibilitiesProvide exceptional patient care under the direction of a Registered Nurse or...
-
Case Management Coordinator
1 month ago
Rancho Cucamonga, United States SIMPLE SOLUTIONS PSYCHOTHERAPY Full time $22Job DescriptionJob DescriptionJob Description: You will be responsible for coordinating and managing the care of patients in various healthcare settings. This is an important role in ensuring the well-being and quality of care for patients. Providing high-quality care to patients and making a positive impact on their livesMajor Job Duties: Maintain Client...
-
Case Management Coordinator
1 month ago
Rancho Cucamonga, United States SIMPLE SOLUTIONS PSYCHOTHERAPY Full timeJob DescriptionJob DescriptionBenefits:Dental insuranceFlexible scheduleFree food & snacksHealth insurancePaid time offOpportunity for advancementTraining & development Job Description: You will be responsible for coordinating and managing the care of patients in various healthcare settings. This is an important role in ensuring the well-being and quality of...
Coordinator - Utilization Management Outpatient
4 months ago
Overview:
What you can expect
Find joy in serving others with IEHP We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic experience
Under the general direction of the UM Outpatient Manager and Supervisor, the Outpatient UM Coordinator, is a high paced position that requires timely processing of authorization requests, verifying eligibility and obtaining additional information as requested by Medical Management or Utilization Management Nurses. This position requires that one be organized, ability to multitask with a working knowledge of ICD.9/10, CPT Coding and Medical Terminology. The Outpatient UM Coordinator will also ensure that provider calls are responded to in an accurate and timely manner while always maintaining highest level of customer service, in addition to collaboration with, inter-departments to ensure member needs are met while simultaneously building strong peer relationships.
Major Functions (Duties and Responsibilities)1. Responsible for monitoring the Right Fax Server. Ensuring all referrals are processed in a timely manner and ensuring compliance with appropriate turnaround timeframes.
2. Responsible for checking the referral form for completeness, obtaining missing demographic information as needed, and initial attempts at coding any uncoded referrals.
3. Responsible for meeting accuracy standards for appropriate authorizations of referrals at the UM Coordinator level.
4. Responsible for representing the Inland Empire Health Plan in a friendly and professional manner while answering the calls for the Utilization Management Department.
5. Communicate with providers in consultation with the Utilization Management Nurse, regarding authorizations, modifications, denials, and other matters pertinent to processing authorization requests or other UM related correspondence.
6. Assist Management or Utilization Management Nurses as requested.
Commitment to Quality: The IEHP Team is committed to incorporate IEHPs Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.
Additional Benefits:Perks
IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.
- Competitive salary.
- CalPERS retirement.
- State of the art fitness center on-site.
- Medical Insurance with Dental and Vision.
- Life, short-term, and long-term disability options
- Career advancement opportunities and professional development.
- Wellness programs that promote a healthy work-life balance.
- Flexible Spending Account Health Care/Childcare
- CalPERS retirement
- 457(b) option with a contribution match
- Paid life insurance for employees
- Pet care insurance
Qualifications:
Education & Experience
- Minimum of three (3) years of experience as a data entry specialist or coordinator.
- High school diploma or GED required.
Key Qualifications
- Requires knowledge of ICD-9/10 and CPT codes.
- Managed Care or physician office a must.
- Skilled in computer applications, including word processing, database, and spreadsheets.
- Good customer service skills.
Start your journey towards a thriving future with IEHP and apply TODAY
Pay Range:USD $23.98 - USD $30.57 /Hr.
