Clinical Utilization Management Coordinator (UM)
About The Position
As the Utilization Management Coordinator, you will support patients and the treatment team by ensuring continued access to appropriate levels of care, advocating for medical necessity with payers, and guiding the treatment plan through clinical collaboration and strategic review. If you're looking to make a meaningful impact in the healthcare industry and be part of a dynamic team, this role is for you. Join us in our mission to provide exceptional care to our patients and support our dedicated staff. Review clinical documentation to support continued stay authorizations. Review the treatment plan and advocate for additional services as indicated. Promote effective use of resources for patients. Ensure that patient rights are upheld. Maintain ongoing contact with the attending physician, program manager, nurse manager, and various members of the team. Collaborate with the treatment team regarding continued stay and discharge planning issues. Advocate that the patient is placed in the appropriate level of care and program. Interface with program staff to facilitate a smooth transition at the time of transfer or discharge.
Requirements
- Bachelor’s or Master’s degree from an accredited college or university in social work, mental health, nursing, or a related degree is required.
- At least two (2) years’ experience in a healthcare setting or managed care company, with experience in patient assessment, treatment planning, utilization management, and/or case management.
Responsibilities
- Review clinical documentation to support continued stay authorizations.
- Review the treatment plan and advocate for additional services as indicated.
- Promote effective use of resources for patients.
- Ensure that patient rights are upheld.
- Maintain ongoing contact with the attending physician, program manager, nurse manager, and various members of the team.
- Collaborate with the treatment team regarding continued stay and discharge planning issues.
- Advocate that the patient is placed in the appropriate level of care and program.
- Interface with program staff to facilitate a smooth transition at the time of transfer or discharge.
Benefits
- 401(k) + matching
- Health insurance
- 100% company-paid life insurance coverage up to 2x your annual salary
- Vision insurance
- Dental insurance
- 100% company-paid long term disability insurance
- Paid time off
- Paid Holidays
- Cafeteria on site + one free meal per day
- Employee engagement events
- Employee assistance program
- Employee recognition program
- Free parking
- Career & training development opportunities
- Dynamic and inclusive work environment
- Engaged management team dedicated to your success
- A guiding mission and set of values that serve as both our northstar and yours, anchoring our collective purpose and aspirations
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
251-500 employees
