Skip navigation
Unable to save this job. Please try again later.


Email this Job to Yourself or a Friend

To begin the application process, please enter your email address.

Company Contact Info

  • Anaheim, CA

Already have an account?

Sign in to apply with your saved resumes.

New to CareerBuilder?

Don't have an account? Continue as a guest!

Sorry, we cannot save or unsave this job right now.

Report this Job

Trust and Site Security Team.

Don't miss out on new jobs!

Get the latest Review Coordinator jobs in Anaheim, CA delivered directly to your inbox. You can unsubscribe at any time.

Saving Your Job Alert

Job Alert Saved!

Could not save Job Alert!

You have too many Job Alerts!

This email address has reached the maximum of 5 email alerts. To create a new alert, you will need to log into your email and unsubscribe from at least one.

Sign Up

or   Sign In Here
Password Must Contain
8 to 15 characters
1 uppercase letter
1 number or symbol
1 lowercase letter
Create an Account with CareerBuilder to save jobs & unlock these great features
See similar job titles and skills to help you make your next move
Upload a resume and become visible to Hiring Managers and Employers
Compare Salary Information to see where you stand amongst your peers
Easily Quick Apply to jobs with just one click!

Email Send Failed!

UM Coordinator

The Judge Group • Anaheim, CA

Posted 12 days ago

Job Snapshot

Other Great Industries

Job Description

We need 2 UM Coordinator temps for the Anaheim location. .

Position Summary:

The Utilization Management (UM) Coordinator is responsible for general, precertification, concurrent and/or retrospective review of inpatient and/or outpatient services. The Utilization Management Coordinator is responsible for data entry of incoming requests, efficient and immediate processing of authorization requests and prepping those requests for nurse review as indicated by pre-determined business rules.  Works with providers, provider office staff, health plans and other internal and external customers to meet the health care needs of members with the appropriate resources.

Essential Job Functions:

Maintain a positive work and team environment            

Assist other staff that supports the team approach.

Verify eligibility, benefits and address other referral request related services from providers and their office staff.

Maintain turnaround time compliance in all aspects of the Prior Authorization and regulatory process.

Data entry of faxed referrals and review for coordinator level for approval

Review the portal referrals for coordinator level for approval

Request notes from provider for review when needed.

Identify “carve out” services and coordinate care with provider for member access to care.

Process special reports assigned.

Recognize when an error has been made and immediately report to appropriate manager.

Perform professional customer service and efficient problem solving for all health services related calls.

Return phone calls to providers and follow up with request in a timely fashion.           

Assist in training when assigned    

Communicate effectively in written in Xpress diary and / or verbally and interact with the providers, and or health plans as indicated     

Uphold health services process according to the policy and procedures.          

Adhere to all company policy and procedures.           

Complete daily work assigned.    

Perform other duties as assigned.

Job ID: 603829
Help us improve CareerBuilder by providing feedback about this job: Report this Job.
For your privacy and protection, when applying to a job online, never give your social security number to a prospective employer, provide credit card or bank account information, or perform any sort of monetary transaction. Learn more.
By applying to a job using CareerBuilder you are agreeing to comply with and be subject to the CareerBuilder Terms and Conditions for use of our website. To use our website, you must agree with the Terms and Conditions and both meet and comply with their provisions.
Don't miss out on new jobs like this
Get the latest jobs delivered to your inbox. Unsubscribe at any time.

Saving Your Job Alert

Job Alert Created

Well, this is embarrassing. We are having trouble saving your search. You can try again or come back at a later time.

Maximum Email Alerts

This email address has reached the maximum of 5 email alerts. To create a new alert, you will need to log into your email and unsubscribe from at least one.