JobMesh

Utilization Management Administration Coordinator - SNF

Humana · US

Become a part of our caring community The UM Administration Coordinator (UMAC) provides non-clinical support for policies ensuring the most appropriate treat...

Job description

Become a part of our caring community The UM Administration Coordinator (UMAC) provides non-clinical support for policies ensuring the most appropriate treatment, care or services for members using services. Reporting to the Manager of Utilization Management, you will work fully remote. You are part of the Home Solutions organization, which contributes to the Skilled Nursing Facility segment. This segment partners with CenterWell and Onehome. As a Utilization Management Administration Coordinator, you will work within defined parameters to meet work expectations and quality standards. Use your skills to make an impact - You will manage NLP's for chart reviews for the nursing team - You will build and pend authorizations for review - You will perform inbound and outbound calls to engage providers and members to verify clinical information/discharge date and admission status throughout the day and will document completed calls and attach clinical information received. - You will request clinical information from providers/facilities - You will create written correspondence - You will create and distribute determination letters - And you will collaborate with multiple roles/department...