Utilization Management Administration Coordinator - SNF
Core
Provide non-clinical administrative support for utilization management policies, ensuring appropriate treatment and care for members by managing chart reviews, authorizations, and provider communications.
Role type
Administrative Coordinator (Utilization Management)
Builds
Authorization determinations, determination letters, and clinical documentation records
Domain
Healthcare / Skilled Nursing Facilities / Managed Care
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Microsoft Office (Word, Outlook, Excel), data entry, inbound/outbound calling, written correspondence, system navigation
Preferred skills
Utilization Review, Prior Authorization, electronic medical records, medical terminology, ICD-10 codes, SNF/Home Health experience, CGX/SRO/HCHB systems
Technologies
Microsoft Office Suite, Electronic Medical Record systems, CGX, SRO, HCHB
Responsibilities
Manage NLPs for chart reviews, build and pend authorizations, verify clinical information via phone, request clinical data from providers, create determination letters, collaborate with multiple departments
Seniority
Entry-level to Junior, hands-on IC