Lead Utilization Coordinator
Catholic Health•East Farmingdale, NY
•Onsite
About The Position
The Lead Utilization Coordinator oversees daily operations of the Managed Care department, ensuring timely and accurate service authorizations. This role supports documentation compliance, coordinates with clinical staff, and maintains relationships with insurance care managers to facilitate appropriate patient care and reimbursement.
Requirements
- Bachelor’s degree required
- Minimum 2 years in home care or managed care setting preferred
- Strong computer proficiency
- Critical thinking
- Knowledge of state/federal home care regulations
Nice To Haves
- LPN, RN, or Social Worker preferred
- Current New York State license (LPN/RN/SW)
Responsibilities
- Supervise Managed Care department workflows and staff coordination
- Ensure accurate, timely authorization of services
- Obtain and review clinical documentation to support visit needs
- Communicate with insurance case managers and external partners
- Monitor reports to prioritize authorizations and resolve issues
- Assist with insurance verification and reimbursement processes as needed
- Support performance improvement initiatives and workflow enhancements
- Promote teamwork and uphold organizational mission and service standards
Benefits
- Great Healthcare benefits
- Education reimbursement of $5,250 annually
- Additional compensation for visits over your caseload
- Generous tuition assistance
- A defined benefit pension plan
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
