Top 67 Utilization management coordinator i Jobs in Seattle, Wa

Utilization Management Coordinator I
Community Health Plan of Washington —Seattle, WA
- $21.00 - $28.98 an hour
- Full-time
- Remote
- Research
- Office
- Analysis skills
- Paid jury duty
- Health savings account
Quick Apply
14d
Scheduling Coordinator - Imaging Dept
Overlake Medical Center and Clinics —Bellevue, WA
- $27.98 - $41.97 an hour
- Full-time
- Hospital
- English
- Mid-level
- Tuition reimbursement
- Employee assistance program
Scheduling Coordinator
Overlake Medical Center and Clinics —Bellevue, WA
- $27.98 - $41.97 an hour
- Full-time
- Hospital
- English
- Mid-level
- Tuition reimbursement
- Employee assistance program
Office Coordinator
Gordon Rees Scully Mansukhani, LLP —Seattle, WA
- $65,000 - $85,000 a year
- Overtime
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Disability insurance
- Health insurance
Lean Coordinator
Onamac Industries, Inc. —Everett, WA
- $45 - $60 an hour
- Full-time
- Engineering
- 3 years
- Mentoring
- Health savings account
- Health insurance
Quick Apply
Business & Operations Coordinator
Ten Gun Design —Redmond, WA
- $85,000 - $100,000 a year
- Full-time
- Marketing
- Customer service
- Mid-level
- Health savings account
- AD&D insurance
Quick Apply
Wellness Coordinator
Optum —Seattle, WA
- $18 - $32 an hour
- Full-time
- Addiction Medicine
- Computer literacy
- Pass drug screening
- AD&D insurance
- Employee stock purchase plan
Account Executive I - Employee Benefits
Lockton, Inc. —Seattle, WA
- $100,000 - $144,000 a year
- Full-time
- 7 years
- Microsoft Excel
- Microsoft Outlook
- Wellness program
- Paid parental leave
Customer Success Manager - SMB
Humanly —Bellevue, WA
- Full-time
- Hybrid work
- Mid-level
- 1 year
- Leadership
- Paid parental leave
- Health insurance
Quick Apply
4d
Brand Operations Manager
Outdoor Research LLC —Seattle, WA
- Full-time
- Mid-level
- Office
- Commercial
Surgical Coordinator Manager
COMPREHENSIVE EYECARE PARTNERS LLC —Federal Way, WA
- $36.06 - $40.87 an hour
- Full-time
- Surgery
- Mid-level
- High school diploma or GED
- Paid holidays
- Health insurance
Quick Apply
13d
Clinical Care Coordinator LPN or BSW
Community Health Plan of Washington —Seattle, WA
- $33.52 - $51.28 an hour
- Overtime
- Remote
- Nursing
- Mid-level
- Office
- Paid jury duty
- Health savings account
Quick Apply
Customer Manager (Natural Channel)
Acosta —Seattle, WA
- $66,000 - $68,000 a year
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Merchandising
Quick Apply
Shuttle Program Manager - Commute
US AMR-Jones Lang LaSalle Americas, Inc. —Seattle, WA
- $95,600 - $117,100 a year
- Weekends as needed
- Microsoft Word
- Background check
- Mid-level
- Paid parental leave
- Paid holidays
Quick Apply
4d
Regional Sales Coordinator - Western US
Zimmer Biomet —Bellevue, WA
- Full-time
- Customer service
- Research
- Mid-level
- Wellness program
11d
Workplace Experience Coordinator - Pokemon
Northwest Center —Bellevue, WA
- $29.19 - $32.28 an hour
- Weekends as needed
- Ability to walk for extended periods
- English
- Mid-level
- Wellness program
- Disability insurance
Crewing Coordinator
Centerline Logistics Corporation —Seattle, WA
- From $80,168.40 a year
- 12 hour shift
- Microsoft Outlook
- English
- Mid-level
- AD&D insurance
- Paid holidays
Moves Lead Coordinator
CBRE —Redmond, WA
- $33.51 an hour
- Full-time
- Microsoft Outlook
- Mid-level
- High school diploma or GED
- Health insurance
- Dental insurance
CHILDREN'S CARE MANAGER AND SYSTEMS COORDINATOR (PROGRAM SUPERVISOR) - OPEN UNTIL FILLED
Kitsap County, WA —Port Orchard, WA
- $99,071.79 - $126,744.82 a year
- Full-time
- LMFT
- Mid-level
- Residential
- AD&D insurance
- Paid holidays
Property Management Coordinator
Ascend —Seattle, WA
- $55,000 - $65,000 a year
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Health insurance
- Dental insurance
Quick Apply

I want to receive the latest job alert for utilization management coordinator i in seattle, wa

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

utilization management coordinator i jobs near seattle, wa

Scheduling Coordinator jobs in Bellevue, WA

Brand Manager jobs in Seattle, WA

Business Operations Manager jobs in Redmond, WA

Account Executive jobs in Seattle, WA

Program Manager jobs in Seattle, WA

Wellness Coordinator jobs in Seattle, WA

Clinical Care Coordinator jobs in Seattle, WA

Facility Coordinator jobs in Bellevue, WA

Program Supervisor jobs in Port Orchard, WA

Utility Manager jobs in Seattle, WA

Office Coordinator jobs in Seattle, WA

Channel Manager jobs in Seattle, WA

Customer Success Manager jobs in Bellevue, WA

Program Coordinator jobs in San Jose, CA

Scheduling Coordinator jobs in Lafayette, LA

Scheduling Coordinator jobs in Asheville, NC

Scheduling Coordinator jobs in Miami, FL

Community Engagement Coordinator jobs in Portland, OR

Aba Scheduling jobs in California

Surgery Scheduling jobs in Remote

Utilization Management Coordinator I

Community Health Plan of Washington -
Seattle, WA

Quick Apply

Job Details

Full-time
$21.00 - $28.98 an hour
14 days ago

Benefits

Paid jury duty
Health savings account
AD&D insurance
Disability insurance
Health insurance
Dental insurance
Flexible spending account
Paid time off
Employee assistance program
Vision insurance
401(k) matching

Qualifications

Customer communication
Research

Full Job Description

Who we are

Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration.

Our commitment is to:

Strive to apply an equity lens to all our work.
Reduce health disparities.
Create an equitable work environment.

About the Role:

The level I UM Coordinator is responsible for administrative functions in processing Utilization Management (UM) organization determinations for services requiring authorization and hospital notification. Utilizing knowledge of Medicare and Medicaid guidelines to facilitate and comply with the UM processes in data entry of authorization requests, eligibility verification, benefit determinations, timely letter fulfilment, and support to UM clinical staff.

To be successful in this role, you:

Have an associate degree, or an equivalent combination of education and highly relevant experience.
Have at least one (1) year of customer service experience, preferred.
Have working experience in a Healthcare setting, preferred.
Have working experience in a Managed Care setting, preferred.
Are knowledgeable of medical terminology and healthcare processes, preferred.
Are knowledgeable of Washington Apple Health and Medicare Advantage Plans, preferred.

Essential functions and Roles and Responsibilities:

Performs data entry for all referral, prior authorizations and hospital notifications; attaches and/or includes clinical documents as needed.
Utilizes knowledge to determine appropriate CPT, HCPC, ICD-10 codes using CMS, NCQA and HCA criteria.
Researches and validates benefit and prior authorization requirements to determine appropriate course of action within the Care Management system.
Reviews, corrects, and approves authorization requests via the web portal; determines appropriate level of complexity and refers cases requiring clinical review to a nurse reviewer.
Reviews completed denial letters for accuracy and adherence to compliance deadlines. Edits and proofreads content for appropriate medical terminology and MCG criteria. Ensures letters are mailed within established timeframes.
Accurately applies policies & procedures, benefit and eligibility standards to all incoming requests.
Conducts research, validates data, and responds to complex inquiries from multiple sources, including but not limited to members, nurses, medical providers, customer service, operations, appeals, case management and care coordination. Escalating issues as needed.
Reporting to work on time and for all scheduled shifts is essential to this position.
Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion.

Knowledge, Skills, and Abilities:

Solid analytical skills and the ability to interpret, evaluate and formulate action plans based upon data.
Knowledge of care management workflow systems.
Effective verbal and written communication skills. Able to communicate with and collaborate effectively with physicians and allied health care providers.
Flexibility and willingness to work in a matrix-management environment.
Demonstrated organizational, time management, and project management skills.
Ability to multi-task and deal with complex assignments on a frequent basis.
Demonstrated proficiency and experience with Microsoft Office products.
Ability to work independently.
Collaborate with others in a respectful manner and ability to maintain confidentiality.
Perform all functions of the job with accuracy, attention to detail and within established timeframes.

As part of our hiring process, the following criteria must be met:

Complete and successfully pass a criminal background check

Criminal History: includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant’s criminal history will be reviewed on a case-by-case basis considering the risk to the business, members, and/employees.

Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency
Vaccination requirement (CHPW offers a process for medical or religious exemptions)
Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation.

Compensation and Benefits:

The position is FLSA Non-Exempt and is not eligible for overtime. Based on market data, this position grade is 38 (see full range below) and has a 5% annual incentive target based on company, department, and individual performance goals.

CHPW offers the following benefits for Full and Part-time employees and their dependents:

Medical, Prescription, Dental, and Vision
Telehealth app
Flexible Spending Accounts, Health Savings Accounts
Basic Life AD&D, Short and Long-Term Disability
Voluntary Life, Critical Care, and Long-Term Care Insurance
401(k) Retirement and generous employer match
Employee Assistance Program and Mental Fitness app
Financial Coaching, Identity Theft Protection
Time off including PTO accrual starting at 17 days per year.
40 hours Community Service volunteer time
10 standard holidays, 2 floating holidays
Compassion time off, jury duty

Sensory/Physical/Mental Requirements:

Sensory*:

Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance.

Physical*:

Extended periods of sitting, computer use, talking and possibly standing
Simple grasp, firm grasp, fine manipulation, pinch, finger dexterity, supination/pronation, wrist flexion
Frequent torso/back static position; occasional stooping, bending, and twisting.
Some kneeling, pushing, pulling, lifting, and carrying (not over 25 pounds), twisting, and reaching.

Mental:

Ability to learn and prioritize multiple tasks at a given time and have the capability of handling demanding situations. Analytical/problem solving/critical thinking ability.

Work Environment:

Office environment Employees who frequently work in front of computer monitors are at risk for environmental exposure to low-grade radiation.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

Quick Apply

Refine Your Search

utilization management coordinator i jobs in seattle, wa

Utilization Management Coordinator I

Scheduling Coordinator - Imaging Dept

Scheduling Coordinator

Office Coordinator

Lean Coordinator

Business & Operations Coordinator

Wellness Coordinator

Account Executive I - Employee Benefits

Customer Success Manager - SMB

Brand Operations Manager

Surgical Coordinator Manager

Clinical Care Coordinator LPN or BSW

Customer Manager (Natural Channel)

Shuttle Program Manager - Commute

Regional Sales Coordinator - Western US

Workplace Experience Coordinator - Pokemon

Crewing Coordinator

Moves Lead Coordinator

CHILDREN'S CARE MANAGER AND SYSTEMS COORDINATOR (PROGRAM SUPERVISOR) - OPEN UNTIL FILLED

Property Management Coordinator

I want to receive the latest job alert for utilization management coordinator i in seattle, wa

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected