UM Coordinator

3 weeks ago

Newtown Square, United States Main Line Health Full time

Could you be our next Utilization Management Coordinator at Mirmont Treatment Center?

Why work as a Utilization Management Coordinator with Main Line Health?

  • Make an Impact As a Utilization Management Coordinator, you will play an integral role in the success of Main Line Health by conducting all level of reviews with Managed Care Organizations (MCOs) to ensure certification and coverage for all patients admitted to Mirmont Treatment Center's detox, rehab, and IOP programs.

  • Develop and Grow your Career Invest in furthering your education through seeking certifications or advanced degrees by taking advantage of our Tuition Reimbursement This position is eligible for up to $6,000 per year based upon your Full or Part Time status.

  • Get Involved Collaborate with the treatment team to ensure documentation is current, ASAM/PCPC criteria is met; internal documentation guidelines (DDAP requirements) are met; and any physician level reviews. Work closely with Patient Accounting (Accounts Receivable) to clarify any authorization discrepancies; pursue payment of uncovered days through retro-reviews; and documentation of lost revenues.

  • Join the Team Like our patients, the Main Line Health Family encompasses a wide range of backgrounds and abilities. Just as each of our patients requires a personalized care plan, each of our employees, physicians, and volunteers, bring distinctive talents to Main Line Health. Regardless of our unique design, we all share a purpose: providing superior service and care.

  • Position-Specific Benefits include: You are eligible for up to 160 hours of paid time off per year based on your Full or Part Time status. We also offer a number of employee discounts to various activities, services, and vendors... And employee parking is always free

Position: Utilization Management Coordinator
Shift: Full Time - Day Shift

Experience:
1. Minimum of three years of behavioral health experience required
2. Knowledge of insurance and MCO's criteria preferred. Computer skills and basic knowledge of medical terminology required.
3. Ability to plan and organize work adequately to express ideas orally and in writing (English) required.

Education:
High School Diploma Required
Bachelor's Degree (BS, BSW, BSN); or RN / LPN from an accredited School of Nursing Preferred.

Licensures/Certifications:
Drug and Alcohol certification, ASAM Certification required within the first year of employment.

Additional Information
  • Requisition ID: 72001
  • Employee Status: Regular
  • Schedule: Full-time
  • Shift: Day Job
  • Pay Range: $19.92 - $30.86
  • Job Grade: 206

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