Case Management, Clinical Study Publications, Clinical Support, Establish Priorities, Health Plan, Healthcare Reimbursement, Home Care, Insurance, Licensed Practical Nurse/Licensed Vocational Nurse, Managed Care, Operations, Organizational Skills, Patient Care, Performance Management, Problem Solving Skills, Reimbursement, Social Work, Support Documentation, Time Management
The Lead Utilization Coordinator oversees daily operations of the Managed Care department, ensuring timely and accurate service authorizations. This role supports documentation compliance, coordinates with clinical staff, and maintains relationships with insurance care managers to facilitate appropriate patient care and reimbursement.
- 5x 8 hour shifts (8:30AM to 4:30PM)
- Great Healthcare benefits, and education reimbursement of $5,250 annually
- Additional compensation for visits over your caseload
Job Details:
Key Responsibilities
- Supervise Managed Care department workflows and staff coordination
- Ensure accurate, timely authorization of services
- Obtain and review clinical documentation to support visit needs
- Communicate with insurance case managers and external partners
- Monitor reports to prioritize authorizations and resolve issues
- Assist with insurance verification and reimbursement processes as needed
- Support performance improvement initiatives and workflow enhancements
- Promote teamwork and uphold organizational mission and service standards
Qualifications
- Education: Bachelor’s degree required; LPN, RN, or Social Worker preferred
- Experience: Minimum 2 years in home care or managed care setting preferred
- Licensure (if applicable): Current New York State license (LPN/RN/SW)
- Skills: Strong computer proficiency, critical thinking, and knowledge of state/federal home care regulations
Posted Salary Range:
USD $65,000.00 - USD $80,000.00 /Yr.
:
This range serves as a good faith estimate and actual pay will encompass a number of factors, including a candidate’s qualifications, skills, competencies and experience. The salary range or rate listed does not include any bonuses/incentive, differential pay or other forms of compensation that may be applicable to this job, and it does not include the value of benefits.
At Catholic Health, we believe in a people-first approach. In addition to the estimated base pay provided, Catholic Health offers generous benefits packages, generous tuition assistance, a defined benefit pension plan, and a culture that supports professional and educational growth.