Utilization Management Coordinator

Job Summary

A company is looking for a Utilization Management Coordinator (Home-Based) - Prior Authorization.

Key Responsibilities

• Monitor resource utilization, risk management, and quality of care for patients
• Obtain and maintain documentation for services in line with reimbursement agency guidelines
• Input collected data into systems for insurance communication and compliance with coverage determinations

Required Qualifications, Training, and Education

• Licensed Practical Nurse (LPN) license or Registered Health Information Technician (RHIT) required
• Seven years of relevant experience preferred
• Minimum one year of healthcare or clinical experience required
• Certifications in coding or pharmacy technician acceptable
• Must maintain required department-specific competencies and certifications