Utilization Management Coordinator
2 weeks ago
Position Overview:
The role of the Utilization Management Coordinator involves overseeing patient care coordination under the guidance of the Medical Directors at UF Health. This position entails managing electronic communications, supporting clinical operations, and providing health counseling to patients.
Key Responsibilities:
- Facilitate patient inquiries regarding medical advice or prescription renewals, ensuring adherence to established practice protocols.
- Gather and evaluate patient information to identify needs and enhance care quality. Communicate with patients through calls and electronic messages concerning care coordination, health maintenance, and appointment scheduling, following provider review.
- Assess and manage medications, laboratory tests, and referrals in alignment with departmental guidelines.
- Prioritize and address tasks within the EPIC system as necessary.
- Ensure continuity of care for established patients by coordinating timely referrals to specialists and ancillary services, subject to provider approval.
- Provide educational resources and guidance to patients to help achieve desired health outcomes, after consultation with the clinic provider.
- Accurately document relevant clinical information in patient records, complying with billing and documentation standards. Close open encounters and manage EMR communications in line with institutional protocols.
- Participate in team meetings, events, and committees, collaborating with interdisciplinary healthcare team members.
- Contribute to the development and enhancement of programs and initiatives, focusing on process improvements and efficient workflows.
- Identify and lead the centralization of the In-Basket triage process, ensuring timely follow-up and decision-making within established guidelines.
Work Environment:
Uphold company policies and demonstrate core values, fostering a culture of open communication and conflict resolution. Maintain a positive and proactive attitude, keeping leadership informed of any issues and recognizing the contributions of others.
Qualifications:
Skills and Competencies:
- Ability to assess patient health and document physiological and growth metrics.
- Proficient knowledge of acute and chronic care protocols, as well as EPIC functionalities.
- Understanding of health promotion strategies and patient education techniques.
- Strong interpersonal and communication skills, capable of engaging effectively with diverse populations.
- Collaborative mindset to work alongside all healthcare team members and clinical services.
- Excellent verbal and written communication abilities.
- Capacity to make informed decisions within the scope of a dependent medical practitioner.
- Strong critical thinking, prioritization, and organizational skills.
Experience:
- Minimum of 2 years in an outpatient healthcare setting is preferred.
Education:
- Bachelor’s degree in a Science or Health-related field is preferred.
Certification:
- Medical Assistant Certification is preferred.
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