Brighton Health Plan Solutions · 4 days ago
Senior UM Coordinator
United States
Full-time
Remote
Mid, Senior Level
$50K/yr - $54K/yr
1+ years exp
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Hiring Manager
Paul Pascale
Insider Connection @Brighton Health Plan Solutions
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Responsibilities
Partner with leadership in cross training team members in all non-clinical departmental functions.
Create cases within the clinical platform while adhering to policies, procedure, and defined workflows.
Support Clinical staff as needed with administrative needs including but not limited to outbound fax requests, telephonic communications, and reporting compilation.
Data entry of required clinical documentation as received via fax or portal submissions.
Telephonic interactions with physicians and/or representatives to acquire information or relay medical determination updates.
Function as a SME (subject matter expert) for the UM Coordinator Team.
Support training of new hires.
Collaborate on the creation and implementation of workflows for the UM Coordinator team.
Assist in supporting escalations if needed from providers and members.
Perform Ad-Hoc projects and support departmental initiatives as needed.
Qualification
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Required
Strong PC skills (Documentation systems, faxing systems, Microsoft Applications)
Excellent organizational skills including written and oral communication skills.
Ability to work independently and as a team.
Minimum of one years’ experience in utilization management functions.
Strong customer service skills required.
History working in medical records review, healthcare, or managed care organizations.
Preferred
JIVA experience/knowledge preferred
Understanding of utilization management functions strongly preferred.
Bilingual preferred, but not required.
Company
Brighton Health Plan Solutions
Brighton Health Plan Solutions is a health care company that specializes in health plan management service.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Jim Cusumano
Co-Founder, President and CEO
Recent News
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