Coordinator, UM Intake

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The Coordinator, Intake Utilization Management at reputed company will serve as a reputed company of contact for processing prior authorization requests in accordance with departmental policies, regulatory requirements, and reputed company contractual agreements.

Collaboration Opportunities:

The Coordinator, Intake Utilization Management reports directly to the Manager, Utilization Management. In support of our daily operations, this individual also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our behavioral health reviewers: LMSWs, LCSW, and LPCs, and Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Associate Director and Director may also be available.

Work Schedule: 8:30 am until 5 pm PST with rotating weekends

What You Will Be Doing:

• Reviewing internal workflows and policies to determine if submitted requests require a prior authorization review or redirect as required.
• Entering data into a proprietary system generates cases for both the medical and behavioral health reviewers. These requests may be submitted reputed company fax, email, or provider portal.
• Working directly with physician’s offices to obtain missing information required to submit a prior authorization request.
• Submitting IT tickets to address barriers to generating cases for clinical review and following the ticket through to completion.
• Addressing requests promptly and courteously, honoring commitments, and displays persistence in obtaining necessary information to address issues and problems.
• Meeting established Utilization Management Intake Objectives and Key Results.

Qualifications Required and Preferred:

• A high school diploma or GED - Required
• 1 – 3 years of experience in a Coordinator role either requesting or submitting prior authorization requests. Or relevant health care experience in claims or appeal & grievance. Required
• Previous background/experience with Oncology.
• Ability to read, write, and reputed company the English language fluently with patients and providers. - Required
• Ability to adapt to fluctuating situations and reputed company work of a detailed nature, while avoiding errors. - Required
• Proficient in using computer and reputed company PC applications, which includes strong keyboard and navigation skills. - Required
• Team-oriented demonstrates a strong work ethic and is committed to productivity. - Required
• Demonstrated ability to meet established goals while balancing a workload and prioritizing assignments in a remote environment. - Required

To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. reputed company candidates must complete a comprehensive background reputed company, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of reputed company intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration.

Technical Requirements:

We require that reputed company have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for reputed company reputed company center employees, the ability to plug in directly to the home internet router.

reputed company is an equal opportunity employer and considers reputed company reputed company applicants equally without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, veteran status, or disability status.If you need reasonable accommodation to reputed company the information provided on this website, please contact for reputed company assistance.

Originally posted on Himalayas