Top 28 Nmm Jobs | SimplyHired

UM Coordinator - Remote
Astrana Health, Inc. —California
- $21 - $24 an hour
- Overtime
- Hybrid work
- Mid-level
- Microsoft Office
- Bachelor's degree
Quick Apply
10d
Associate Professor of Clinical Sciences
Baptist Memorial Health —Memphis, TN
- Full-time
- Background check
- Medicine
- Microsoft Outlook
Risk Adjustment Coordinator - Los Angeles
Astrana Health, Inc. —Los Angeles, CA
- $25 - $27 an hour
- Email
- Hybrid work
- Microsoft Excel
- Up to 50% travel
- HIPAA
Quick Apply
Physician - Integrative Medicine
Sanford Health —Fargo, ND
- Full-time
- Medicine
- Clinic
- Senior level
- Disability insurance
- Health insurance
Quick Apply
Family Medicine Residency Core Faculty, DO
Puyallup Tribal Health Authority —Tacoma, WA
- $241,702.35 - $253,787.47 a year
- Full-time
- Psychiatry
- PALS Certification
- Inpatient
- Profit sharing
- AD&D insurance
Quick Apply
NM - Faculty - Osteopathic Manipulative Medicine
Burrell College of Health Sciences —Las Cruces, NM
- Full-time
- Laboratory
- Medicine
- BC/BE
Quick Apply
Sr Principal Power Systems Engineer - Transmission Modeling
Aspen Technology —Remote
- Full-time
- 11+ years
- Master's degree
- Mentoring
Osteopathic (OPP) - Clinical Teaching Faculty
Idaho College of Osteopathic Medicine —Meridian, ID
- Full-time
- Laboratory
- Classroom
- Medicine
- AD&D insurance
- Paid holidays
Quick Apply
Assistant Professor - Department of Primary Care, Division of Osteopathic Manual Medicine (OMM)
Des Moines University —Des Moines, IA
- Full-time
- Medicine
- Surgery
- BC/BE
- Health insurance
- Tuition reimbursement
Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine Physician
Prime Healthcare, PC —West Hartford, CT
- Full-time
- Private practice
- Spanish
- Primary Care
- Profit sharing
- COVID-19 protective measures
Quick Apply
Assistant/Associate Professor of Osteopathic Principles and Practices/Physician-2 Positions to be Filled
Sam Houston State University —Huntsville, TX
- Multiple hires
- Medicine
- Clinic
- University
- Tuition reimbursement
Faculty Osteopathic Medicine - Meritus School of Osteopathic Medicine
MSOM INC —Hagerstown, MD
- Classroom
- Medicine
- OSHA
- Health savings account
- Disability insurance
Quick Apply
College of Osteopathic Medicine - Founding Chair OMM/OPP - Tenure Track Faculty
Indiana University of Pennsylvania —Indiana, PA
- Online Application
- Classroom
- Medicine
- BC/BE
Assistant/Associate Dean for Osteopathic Integration
KHSC —Wichita, KS
- Full-time
- Medicine
- BC/BE
- Public speaking
- Disability insurance
- Health insurance
Faculty Position for Clinical Sciences, OMM
WILLIAM CAREY UNIVERSITY —Hattiesburg, MS
- Medicine
- OSHA
- BC/BE
Clinical Faculty - Osteopathic Manipulative Medicine/Neuromusculoskeletal Medicine-KHSU
KHSC —Wichita, KS
- Full-time
- Medicine
- BC/BE
- Public speaking
- Disability insurance
- Health insurance
Clinical Asst Professor - OMS1 Program Director - CCOM - 0.3 FTE
Midwestern University —Downers Grove, IL
- Medicine
- 3 years
- Math
Pediatric Osteopathic Manipulative Medicine Physician
Tenet Practice Resources —Detroit, MI
- Full-time
- Medicine
- BC/BE
- BLS Certification
- Relocation assistance
- Dental insurance
Clinical Assistant Professor - AZCOM
Midwestern University —Glendale, AZ
- Full-time
- Medicine
- BC/BE
- Clinic
- Paid holidays
- Disability insurance
Associate Professor of Clinical Sciences
Baptist Memorial Health Care —Memphis, TN
- Background check
- Medicine
- Microsoft Outlook

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UM Coordinator - Remote

Astrana Health, Inc. -
California

Quick Apply

Job Details

Full-time
$21 - $24 an hour
10 days ago

Qualifications

Customer communication

Full Job Description

Description

Astrana Health is seeking a dedicated California-based Utilization Management (UM) Coordinator to support the UM department in reviewing, monitoring, and processing prior authorization requests while ensuring compliance with regulatory standards and health plan guidelines. The UM Coordinator will serve as a key liaison between providers, members, and internal clinical staff, delivering excellent customer service and ensuring accurate documentation and timely processing of referrals. This role is responsible for coordinating and documenting medical review activities to confirm that services meet established criteria for medical necessity, appropriateness, and efficiency, while facilitating clear and timely communication across all stakeholders.

Our Values:

Put Patients First
Empower Entrepreneurial Provider and Care Teams
Operate with Integrity & Excellence
Be Innovative
Work As One Team

What You'll Do

Comply with UM policies and procedures. Annual review of selected UM policies.
Read and understand NMM UM Customer Service Policy and Procedures
Process Routine & Urgent treatment authorization requests according to the NMM Policy & Procedure Manual based on UM Level 1 review process.
Assist with attaching incoming notes to appropriate authorizations
Move referrals coming back from eligibility and or benefits to the correct queue for review
Accurately review, screen and process daily assigned UM referrals (avg 150-250) in accordance with IPA and health plan TAT guidelines
Responsible for verification to include but not limited to: benefit matrix through DOFR, eligibility, provider status (contracted/non-contracted), carved out and others.
Contact providers office as needed for clarification, notes or redirections
Verify that facilities are contracted and or a CMS approved facility when required.
Attend to provider and interdepartmental calls in accordance with exceptional customer service
Reports to UM Lead 3 on activities or problems occurring throughout the day.
Maintains strictest confidentiality at all times.
Maintain good relationships with health plans and medical directors and external contacts.
Team skills, assist others as needed in order to comply with TAT.
Other duties as assigned

Qualifications

High School Graduate, Bachelor's in Healthcare Administration is a plus
At least two years experienced in managed care environment to include but not limited to an IPA or MSO preferred
Knowledge of medical terminology, RVS, CPT, HPCS, ICD-9 codes
Proficient with Microsoft applications, EZCAP preferred
Good organizational skills, verbal and written communication skills
Ability to multitask and problem solve in a fast pace work environment
Punctuality and detail-oriented
Ability to follow directions and perform work independently according to department standards
Must be a strong team player and have excellent attendance record

Environmental Job Requirements and Working Conditions

This is a remote position. The home office is aligned at 1600 Corporate Center Drive in Monterey Park, California. Candidates within a 35 mile radius of the office may be required to work on a hybrid schedule out of the office.
This position requires open availability between M-Su, 8 A - 8 P. You would be scheduled for 5 shifts a week, weekends and holidays are rotated amongst the team, and there is overtime in this position!
The national target pay range for this role is $21.00 - $24.00 per hour. Actual compensation will be based on geographic location (current or future), experience, and other job-related factors.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at [email protected] to request an accommodation.

Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

About Astrana Health, Inc.

Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient.

Our platform currently empowers over 20,000 physicians to provide care for over 1.7 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.

Quick Apply

Refine Your Search

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UM Coordinator - Remote

Associate Professor of Clinical Sciences

Risk Adjustment Coordinator - Los Angeles

Physician - Integrative Medicine

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NM - Faculty - Osteopathic Manipulative Medicine

Sr Principal Power Systems Engineer - Transmission Modeling

Osteopathic (OPP) - Clinical Teaching Faculty

Assistant Professor - Department of Primary Care, Division of Osteopathic Manual Medicine (OMM)

Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine Physician

Assistant/Associate Professor of Osteopathic Principles and Practices/Physician-2 Positions to be Filled

Faculty Osteopathic Medicine - Meritus School of Osteopathic Medicine

College of Osteopathic Medicine - Founding Chair OMM/OPP - Tenure Track Faculty

Assistant/Associate Dean for Osteopathic Integration

Faculty Position for Clinical Sciences, OMM

Clinical Faculty - Osteopathic Manipulative Medicine/Neuromusculoskeletal Medicine-KHSU

Clinical Asst Professor - OMS1 Program Director - CCOM - 0.3 FTE

Pediatric Osteopathic Manipulative Medicine Physician

Clinical Assistant Professor - AZCOM

Associate Professor of Clinical Sciences

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