UM Coordinator Temp

Job Description

Job Description

Medica Talent Group is excited to share this Temp to Hire opportunity with you!

We are looking for Utilization Management Coordinator seeking a new exciting opportunity! Our client offers growth and an exciting workplace to join along with competitive salary rates, great benefits , RN programs, and tuition reimbursement!

For immediate consideration, Please submit your resume to : bchairez@medicatg.com

Pay : $22 -24hr

UM Coordinator Overview

This position has primary responsibility for gathering relevant information for the identified member population during

assessment, care planning, interdisciplinary care team meeting, and transitions of care. This position performs troubleshooting when problems situations arise and takes independent action to resolve complex issues.

Qualifications

1. High School Diploma or equivalent required.

2. Prior experience working in a clinic / health care call center.

3. Minimum 2 years of experience working in a health care environment; knowledge of prior authorization and

case management regulations governing Medi-Cal, Commercial, Medicare, CCS, and other government and

commercial programs.

4. Prefer experience in a managed health care environment, preferably IPA, HMO, or Health Plan.

5. Prefer experience working with an ethnically diverse population.

UM Coordinator Essential Job Duties & Responsibilities :

1. Input data into the case management system to ensure timely care coordination and outreach.

2. Verifies member benefits and eligibility upon receipt of care coordination and / or case management.

3. Utilizes DOFR and / or delegation agreements to drive decision-making.

4. Coordinates and assists with patient appointments, transportation, and / or community resources.

5. Has primary responsibility for gathering relevant information for the identified member population during

assessment, care planning, interdisciplinary care team meeting, and transitions of care.

6. Completes applicable patient assessments.

7. Completes problem solving and coordination for patients in collaboration with case manager.

8. Outreach to patients to verify that needs are being met and services are being delivered.

9. Intervenes at the client level to coordinate the delivery of direct services to clients and their families.

10. Coordinates with Primary Care and Specialist providers.

Locations Available :

Montebello, CA

Utilization Management Coordinator

INDMED