[Hiring] UM Coordinator, Pre-Service @Alignment Health

Role Description

Alignment Health is seeking an organized, detail-oriented and customer service oriented utilization management (UM) Coordinator to join the utilization management pre-service team. As a UM coordinator, you get to assist and support the clinical team, UM nurse, and medical director with administrative tasks related to processing UM's clinical referrals.

If you are hungry to learn and grow, want to be part of a growing organization, and make a positive impact in the lives of seniors – we’re looking for you!

Schedule: (Required)

• Monday - Friday
• 8am - 5pm Pacific Time

Qualifications

• Minimum (1) year experience in a medical setting working with IPAs, entering referrals / prior authorizations preferred.
• Knowledge of ICD10, CPT codes, Medicare Managed Care Plans, medical terminology (certificate preferred) and referral system (Access Express/Portal/N-coder).
• High school diploma or general education degree (GED) and / or training: or equivalent combination of education and experience required.
• Computer proficient.
• Able to type minimum 50 words per minute (WPM).
• Experience with Microsoft Office (Word, Excel, Outlook).
• Experience with the application of UM criteria (i.e., CMS National and Local Coverage Determinations, etc.).
• Bilingual English / Spanish preferred.

Requirements

• Medical assistant experience preferred.
• Knowledge working in Access Express / Portal, Epic preferred.

Benefits

• Pay Range: $41,472.00 - $62,208.00
• Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Essential Physical Functions

• While performing the duties of this job, the employee is regularly required to talk or hear.
• The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
• The employee frequently lifts and / or moves up to 10 pounds.
• Specific vision abilities required by this job include close vision and the ability to adjust focus.