UM Coordinator

3 weeks ago

Rancho Cucamonga, United States AppleOne Full time
Job DescriptionJob DescriptionJoin our team as an Outpatient Utilization Management (UM) Coordinator, where you’ll play a key role in referral processing and provider communication, all while working remotely.

Key Responsibilities:
Process referrals promptly, ensuring compliance with turnaround timeframes.
Verify referral completeness, update demographics, and assist with initial coding.
Communicate professionally with providers and UM Nurses about authorizations and modifications.
Collaborate with departments to meet member needs and maintain strong relationships.
Qualifications:

High school diploma or GED required.
3+ years of experience in data entry or coordination in managed care or a physician’s office.
Knowledge of ICD-9/10, CPT codes, and medical terminology.
Skilled in computer applications (word processing, databases, spreadsheets).
Excellent customer service and organizational skills.
Why Join Us?

Fully remote work environment.
Competitive pay and benefits.
Opportunity to make an impact in a collaborative and supportive team.

EEO/AA Employer/Vet/Disabled.

The Know Your Rights poster is available here:
https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdf

The pay transparency policy is available here:
https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf

For temporary assignments lasting 13 weeks or longer, the Company is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.

We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.

AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.
https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf

We also consider qualified applicants regardless of criminal histories, consistent with legal requirements. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

#1062

Company DescriptionFounder and CEO, Janice Bryant Howroyd, is a North Carolina native who left her hometown in 1976 armed with $1500. Since then, she has dedicated her efforts to building an organization that is committed to keeping the humanity in Human Resources and Strategic, Inclusive Procurement.

Mrs. Howroyd’s commitment to excellence has grown ActOne Group to 33 countries, with over 17,000 clients and more than 2,800 employees. The largest woman-minority-owned workforce management company founded in the US, ActOne Group professionals bring expertise in delivering corporate HR initiatives to local and global markets.

Mrs. Howroyd was selected by former President Barack Obama to serve as a White House appointee and continues to serve under the current administration as an Ambassador of Energy. Mrs. Howroyd gives generously through funding and advocacy for STEM education, particularly for women and minorities.

Mrs. Howroyd leads her teams to build business success based on the ability to connect great companies with outstanding talent. Her passion for education, mentorship, and self-empowerment initiatives have earned her many professional and philanthropic recognitions. She is a sought–after speaker and media subject matter expert in her fields. Her book, The Art of Work: How to Make Work, Work for You, is available on Amazon.com.Company DescriptionFounder and CEO, Janice Bryant Howroyd, is a North Carolina native who left her hometown in 1976 armed with $1500. Since then, she has dedicated her efforts to building an organization that is committed to keeping the humanity in Human Resources and Strategic, Inclusive Procurement.\r
\r
Mrs. Howroyd’s commitment to excellence has grown ActOne Group to 33 countries, with over 17,000 clients and more than 2,800 employees. The largest woman-minority-owned workforce management company founded in the US, ActOne Group professionals bring expertise in delivering corporate HR initiatives to local and global markets.\r
\r
Mrs. Howroyd was selected by former President Barack Obama to serve as a White House appointee and continues to serve under the current administration as an Ambassador of Energy. Mrs. Howroyd gives generously through funding and advocacy for STEM education, particularly for women and minorities.\r
\r
Mrs. Howroyd leads her teams to build business success based on the ability to connect great companies with outstanding talent. Her passion for education, mentorship, and self-empowerment initiatives have earned her many professional and philanthropic recognitions. She is a sought–after speaker and media subject matter expert in her fields. Her book, The Art of Work: How to Make Work, Work for You, is available on Amazon.com.

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