• 1376473025145
  • Utilization Management Coordinator

    Requisition #86114
    Affinity Medical Solutions
    Richmond, CA

    POSITION DETAILS

    An exciting new opportunity exists for a Utilization Management Coordinator with Affinity Medical Solutions in Richmond, CA, affiliated with University HealthCare Alliance (UHA), Stanford Hospital & Clinics' new medical foundation.

    The Utilization Management Coordinator is responsible for processing inpatient and outpatient provider authorization requests in order to ensure member eligibility and benefit availability while focusing on the use of preferred providers. This position completes approvals with required documentation within regulatory timeframes and will notify members and providers of determinations verbally and in writing per requirements.

    DESIRED SKILLS AND EXPERIENCE

    The ideal candidate will have two (2) years of college or equivalent work experience, two or more years of working experience in a managed care environment having utilized managed care systems, regulations, CPT, ICD-9, and HCPCS codes. General knowledge of ancillary and hospital based services and contracts, healthcare claims processes, capitation, and healthcare operations and familiarity with various healthcare delivery models. Additionally, experience in the use of various system software as well as Windows, Microsoft Word, Excel (PowerPoint a plus).

    BA/BS Degree, Medical Assistant certificate, or IPA or Health Plan Experience is preferred. Working in a utilization management/prior authorization setting is also preferred.

    Apply

    We invite you to send your resume and cover letter to affinitymdhr@affinitymd.com. Please include "Utilization Coordinator - Req #86114" in the subject line.

    Equal Opportunity Employer