UM Coordinator

Primary Responsibilities

• Affords assistance in the prior authorization of services and ongoing authorization requests.
• Affords assistance in completing authorization updates as needed based on the care plan of the member.
• Coordinates with providers regarding authorization activities.
• Coordinates communication between authorization clinical staff, members and providers as needed.
• Serves as a liaison and member advocate between the member/family, physician(s) and the care team to ensure timely and effective communication in regards to the member’s care.
• Participates in case round meetings and on-going education activities.
• Ensures that all job responsibilities are carried out in compliance with CPHL and State and Federal regulations.

Education and Experience

• Education Required: HS Diploma
• PREFERRED: Bachelor’s Degree
• Type of Experience Required: Strong written and verbal communication skills
• Computer proficiency
• Strong multi-tasking abilities
• PREFERRED: Experience working within a managed care environment
• Specific Technical Skills Preferred: Computer proficiency in Microsoft Office applications

Scope Information

• # Direct Reports: 0

Physical Requirements

• Must be able to operate a computer and telephone

Qualifications

Required: None

Benefits

Centers Plan For Healthy Living is committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our employees and our business. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law and will not be denied employment.