VirtualVocations

Compensation

Full Description

A company is looking for a Utilization Management Coordinator to process prior authorization requests and ensure compliance with regulatory guidelines. Key Responsibilities Process prior authorization requests and ensure adherence to internal policies and regulatory guidelines Forward requests to clinicians for medical review and communicate approved procedures to providers and members Maintain logs and records, participate in departmental statistics compilation, and engage in process improvement activities Required Qualifications Two to four years of experience in UM healthcare management or equivalent education and experience Experience in a Health Care Management or HMO environment Familiarity with utilization review / utilization management processes Basic understanding of LCD / NCD and Utilization Management functions Strong computer skills, particularly in MS Office products, including MS Excel