Job Openings in Sacramento County and Beyond

Utilization Management Coordinator (UMC)

SACRAMENTO, CA 95831

Posted: 07/15/2024 Employment Type: Contract Industry: Healthcare Job Number: 1685194

Job Description

We are recruiting for a Utilization Management Coordinator (UMC) for an established healthcare organization in Sacramento. The UM Coordinator supports activities related to authorization processing for outpatient, inpatient and ambulatory services. This is a contract to hire opportunity! The ideal candidate has experience with medical referrals, authorizations, health plans and excellent patient customer service. Pay: $18-$21/hour DOE.


RESPONSIBILITIES:

  • Compile daily inpatient log; review specified UM reports.

  • Process referrals, generate denial letters and perform retro-review coordination. 

  • Acts as liaison to the providers’ offices and the UM/QM staff.  

  • Provide clerical assistance and prepare reports for the UM/QM Supervisor, Manager and/or Director of Medical Management.

  • Answer telephone; screen and direct calls to appropriate staff member or department. 

  • Effectively works with providers, nurses, case managers, UM/QM Manager(s), and Medical Directors to ensure system inputs of manual referrals are processed, timely and accurately.

  • Receive and enters appropriate information from referrals.

  • Update, maintain, and notify health plans of inpatient census information on daily basis.

  • Assist with examination of records, related documents, corresponds with providers and health plan personnel to obtain facts regarding member concerns/complaints.

  • Verify member eligibility by systems inquiry or health plan contact. 

  • Request clinical records per procedure.


QUALIFICATIONS:

  • High School Diploma or GED required. AA degree in related field is preferred.

  • Medical Assistant/Certified preferred.

  • 2+ years utilization management coordination experience is required. Minimum of 3 years’ experience in the medical field is required.

  • Type minimum of 45 WPM.

  • Ability to multi-task, problem solve and analyze data in a fast-paced environment.

  • Demonstrated ability to intervene and diffuse difficult calls. 

  • Proficiency with MS Office applications.

  • Excellent communication skills, both oral and written.

  • Ability to maintain confidentiality and appropriately share information on a need-to-know basis.

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About SACRAMENTO, CA

Ready to kickstart your career in the vibrant Sacramento, California area? This bustling region is not only the capital of the Golden State but also a hub of endless job opportunities and growth potential. From the stunning Tower Bridge crossing the scenic Sacramento River to the delectable farm-to-fork dining scene that's second to none, Sacramento has something for everyone. Catch a performance at the historic Crest Theatre, cheer on the Sacramento Kings at the Golden 1 Center, or discover local artists at the Crocker Art Museum. With the majestic Sierra Nevada mountains nearby and the beautiful parks like the McKinley Park to explore, Sacramento offers an enchanting blend of culture, creativity, and charm that will truly make your career journey unforgettable. Dive into our job listings today and set your sights on a rewarding career in this unforgettable region!