Utilization Management Coordinator

ESSENTIAL DUTIES

• Letters of agreement
• • Timely review of all requests for letters of agreement assigned to work queue
  • Verifying letter of agreement criteria is met
  • • Services not available in network
    • Continuation of Care
  • Verifying information provided is sufficient to submit for letter of agreement
  • Submitting letters of agreement to Contracting Contacts for entities financially responsible for services
  • Follow up and follow through for status and completion of letter of agreement.

MINIMUM REQUIREMENTS

• Understanding of basic medical terminology
• Organized, efficient and possess superior attention to detail
• Punctual, prepared and able to meet or beat deadlines
• Excellent written and verbal communication skills
• Managed Care Healthcare Experience a plus

EDUCATION/TRAINING

• High School diploma
• College degree preferred
• On Site training will be provided

LANGUAGE SKILLS

• Ability to communicate and speak effectively before co-workers, management, and external contacts
• Ability to fluently speak, write, and understand English
• Ability to write routine emails and other correspondence
• Ability to speak clearly and concisely over the telephone

CONFIDENTIAL AND SENSITIVE INFORMATION:

• Must properly control the release of proprietary and confidential information

Note that the information above is intended to describe the general nature and level of work being performed by employees, and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of personnel so classified. Furthermore, they do not establish a contract for employment and are subject to change at the discretion of the employer.

Thrifty Management Services is the dedicated MSO for Preferred IPA of California, providing the best possible care management, care coordination, and claims processing services to Preferred IPA and their members. We work with the network’s participating physicians to coordinate patient care when a referral is made to a specialist or hospital for diagnosis and treatment. We coordinate patient care across all aspects of the provider network. We provide high quality services to its participating physicians and superior health care to its members.