Utilization Management Coordinator (Hybrid) Job Listing at MedStar Health in Columbia, MD (Job ID 158451)

Description

About the Job

Location: Hybrid/Columbia, MD

Schedule: Monday-Friday, 8:30am-5:00pm

Minimum of 2 days a week will be in the office. Initial training could be daily for the first few of weeks.

General Summary of Position
Provides administrative and operational support including accurate and efficient management of incoming calls faxes and authorization intake. Responsible for managing outgoing correspondence and administrative processes for the clinical operations department. Will also support UM Nurses with building shells of preauthorization requests maternity authorizations making initial requests for clinical information sending inpatient reviews to the nurses and updating case notes and special projects.

Primary Duties and Responsibilities

• Contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Complies with governmental and accreditation regulations.
• Accountable for reviewing and screening incoming documents and distribute to appropriate staff.
• Actively manages incoming calls to collect appropriate information assesses and identifies caller needs with efficiency and/or to courteously direct the calls to the appropriate staff in a timely manner per MFC's guidelines. Processes returned UM mail for remailing.
• Acts as a liaison to providers and members to communicate status of authorization decisions or need for additional information.
• Demonstrates behavior consistent with MedStar Health mission vision goals objectives and patient care philosophy.
• Ensures complete communication (closes the loop and follow up) between key internal and external customers.
• Enters accurate data into the clinical software system related to pre-authorization requests for non-pharmacy and hospitalizations.
• Maintains timely and accurate documentation in the clinical documentation system.
• Organizes and maintains data for targeted initiatives and maintaining timely outreach to members and providers as indicated.
• Participates in multidisciplinary quality and service improvement teams as appropriate. Participates in meetings serves on committees and represents the department and hospital/facility in community outreach efforts as appropriate.
• Performs telephonic ACD (Automatic Call Distribution) phone line coverage for Clinical Operations' needs.
• Disseminates messages in an appropriate and timely manner.
• Complete detailed minutes for team or staff meetings as needed.
• Processes telephone inquiries and communicates accurate knowledge of policies and procedures. Projects a positive image on the telephone to internal /external customers. Represents the best of MedStar Health (MFC) at all times and to all customers.
• Works collaboratively with the Utilization management/ clinical team and other customers internally and externally to meet the needs of the population.
• Ensures complete communication (closes the loop and follow up) between key customer groups including internal and external customers.
• Will outreach requesting provider on any authorization requests that are not accompanied by supporting medical documentation.

Minimal Qualifications
Education

• High School Diploma or GED required
• Associate's degree preferred

Experience

• 2 years clerical/office experience including customer service, experience medical office preferred

Knowledge Skills and Abilities

• Ability to type 50 words per minute.
• Proficient with Microsoft Office Word and Excel.
• Ability to use multiple computer applications.
• Ability to operate standard office equipment.
• Ability to multitask and prioritize daily workload.
• Ability to work independently as part of a team and display innovation capability and initiative.
• Excellent verbal and written communication skills.
• Knowledge of medical terminology preferred.