Top 2558 Um 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
UM Authorization Analyst 2 Bilingual
The Oncology Institute of Hope and Innovation —Fort Lauderdale, FL
- $71,000 - $85,000 a year
- Remote
- Spanish
- Customer service
- English
Quick Apply
UM Coordinator
Centers Plan for Healthy Living —Margate, FL
- Full-time
- Computer literacy
- High school diploma or GED
- Bachelor's degree
Quick Apply
Booking Specialist
Community Labor Partnership —North Carolina
- $15 - $18 an hour
- Contract
- Remote
- Entry level
- On-the-job training
- Work from home
Quick Apply
6d
UM Coordinator - Denials
Astrana Health, Inc. —Monterey Park, CA
- $21 - $26 an hour
- Overtime
- Hybrid work
- Mid-level
- Office
- High school diploma or GED
Quick Apply
Physician Reviewer
MedReview —Remote
- $230,000 a year
- Full-time
- Remote
- Medicine
- 5 years
- BC/BE
Quick Apply
UM Review Nurse
Astrana Health, Inc. —California
- $34 - $47 an hour
- Overtime
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook
Quick Apply
Coordinator, UM Intake
Evolent Health —Remote
- $18 - $20 an hour
- Full-time
- Background check
- Computer literacy
- Pass drug screening
- Health insurance
UM Coordinator
Imperial Management Administrators Services Inc —Pasadena, CA
- $20 - $22 an hour
- Full-time
- Medical office experience
- HIPAA
- High school diploma or GED
Quick Apply
UM Coordinator
Advanced Medical Management —Long Beach, CA
- $23 - $27 an hour
- Full-time
- Microsoft Word
- Microsoft Outlook
- Computer literacy
- Paid holidays
- Health insurance
Quick Apply
10d
UM Nurse Specialist (HYBRID)
TEXASCONNECT INC —Dallas, TX
- Full-time
- Hybrid work
- Bilingual
- LVN
- Mid-level
Post-Acute UM Supervisor
Devoted Health —Remote
- $95,000 - $120,000 a year
- Full-time
- RN License
- Mid-level
- 1 year
- Dental insurance
- 401(k)
Unternehmensnachfolger (w/m/d)
EterniTeam GmbH —Hannover, ND
Quick Apply
UM Care Coordinator
Centers Plan for Healthy Living —Staten Island, NY
- $17.95 - $20.51 an hour
- Full-time
- Computer literacy
- High school diploma or GED
- Bachelor's degree
Quick Apply
Utilization Review Coordinator
MEADOWS OF WICKENBURG INC —Phoenix, AZ
- Full-time
- Remote
- Mid-level
- Residential
- 3 years
Quick Apply
UM BH Registered Nurse
Humana —New Jersey
- Part-time
- Remote
- Nursing
- RN License
- Military
- Work from home
Physician Advisor - CDI Experience Required
Northeast Georgia Health System —Gainesville, GA
- 8 hour shift
- Medicine
- 7 years
- Writing skills
Chief Medical Officer - Family or Int Medicine
Mission City Community Network —North Hills, CA
- $295,500 - $380,000 a year
- Email
- Medicine
- Doctoral degree
- Psychiatry
- Paid holidays
- Health insurance
Quick Apply
Time for a Change...School-Based Occupational Therapist (OT)
IntelliChoice Home Care —Creedmoor, NC
- School experience
- Mid-level
- Master's degree
UM Case Manager/Appeals Coordinator
Havenwyck Hospital (UHS) —Auburn Hills, MI
- $60,000 - $69,000 a year
- Full-time
- Background check
- LMFT
- Nursing
- Loan repayment program
- Health insurance
Quick Apply

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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

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UM Coordinator - Remote

UM Authorization Analyst 2 Bilingual

UM Coordinator

Booking Specialist

UM Coordinator - Denials

Physician Reviewer

UM Review Nurse

Coordinator, UM Intake

UM Coordinator

UM Coordinator

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Post-Acute UM Supervisor

Unternehmensnachfolger (w/m/d)

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Utilization Review Coordinator

UM BH Registered Nurse

Physician Advisor - CDI Experience Required

Chief Medical Officer - Family or Int Medicine

Time for a Change...School-Based Occupational Therapist (OT)

UM Case Manager/Appeals Coordinator

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