Per Diem UM Case Manager
About The Position
Could you be our next Per Diem UM Case Manager at Mirmont Treatment Center? Why work as a UM Case Manager? Make an Impact! A Utilization Management Coordinator is responsible for conducting all level of reviews with insurance payors to ensure certification and coverage for all patients admitted to Mirmont's Inpatient treatment facility, Partial Hospitalization Programs (PHP) and Intensive Outpatient Programs (IOP) at Mirmont Outpatient Centers. The UM Coordinator collaborates with the treatment team to ensure documentation is current and complete and meets established clinical criteria and guidelines. The UM Coordinator works closely with Patient Accounting (Accounts Receivable) to clarify any authorization discrepancies; pursue payment of uncovered days through retrospective reviews; and documentation of lost revenues. Get Involved! Become engaged by joining hospital & system-wide Nursing Committees, Unit Councils, and evidence-based research projects. 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 common purpose: providing superior service and care. Position-Specific Benefits include: We offer a number of employee discounts to various activities, services and vendors... And parking is always free! Position: Per Diem UM Case Manager Shift: Per Diem, Varied Days; 7:00 am to 3:30 pm
Requirements
- Three years of behavioral health experience
- Minimum High School Diploma
- Bachelor's Degree (BS, BSW, BSN) or RN, LPN, from accredited School of Nursing preferred.
- Drug and Alcohol certification, ASAM Certification required within the first year of employment.
Nice To Haves
- Knowledge of insurance criteria preferred.
- Basic knowledge of medical terminology.
Responsibilities
- conducting all level of reviews with insurance payors to ensure certification and coverage for all patients admitted to Mirmont's Inpatient treatment facility, Partial Hospitalization Programs (PHP) and Intensive Outpatient Programs (IOP) at Mirmont Outpatient Centers
- collaborates with the treatment team to ensure documentation is current and complete and meets established clinical criteria and guidelines
- works closely with Patient Accounting (Accounts Receivable) to clarify any authorization discrepancies
- pursue payment of uncovered days through retrospective reviews
- documentation of lost revenues
Benefits
- employee discounts to various activities, services and vendors
- parking is always free
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What This Job Offers
Job Type
Part-time
Number of Employees
5,001-10,000 employees
