Top 65 Non clinical um specialist Jobs

Transportation Specialist I
Partnership HealthPlan of California —Redding, CA
- $28.52 - $33.51 an hour
- Full-time
- Spanish
- Computer literacy
- Writing skills
Clinical Specialist, Quality Management I
Personify Health —Remote
- $60,600 - $91,000 a year
- Email
- Remote
- Nursing
- Microsoft Outlook
- RN License
- Health insurance
- Dental insurance
Quality Management Specialist
University of Maryland Medical System —Bel Air, MD
- $42.64 - $64.00 an hour
- Full-time
- Nursing
- RN License
- Writing skills
Payor Specialist- Weekends
SYSTEM West Virginia University Health System —Remote
- Weekends as needed
- Remote
- Computer literacy
- Mid-level
- Office
Utilization Management Specialist
HealthCare Partners, MSO —Garden City, NY
- $31 - $36 an hour
- Full-time
- Microsoft Outlook
- Customer service
- 5 years
- Health insurance
- Dental insurance
Quick Apply
Provider Contract Specialist (Field Remote)
Alignment Healthcare USA, LLC —Orange, CA
- $59,877 - $89,816 a year
- Extended hours
- Remote
- Microsoft Word
- Microsoft Access
- Mid-level
- Mileage reimbursement
Quick Apply
7d
Intake Specialist- Hybrid-AZ
Personify Health —Tempe, AZ
- $17 - $20 an hour
- Email
- Hybrid work
- Microsoft Outlook
- Computer literacy
- HIPAA
- Health insurance
- Dental insurance
5d
Utilization Specialist - Full Time
The Camp Recovery Center —Scotts Valley, CA
- $25 - $27 an hour
- 8 hour shift
- CPR Certification
- Nursing
- RN License
- Health insurance
- Dental insurance
CSP Utilization Review Specialist/Quality Manager
Pascua Yaqui Tribe —Tucson, AZ
- $5,535.14 a month
- Weekends as needed
- Spanish
- Psychiatry
- Writing skills
Clinical Document Spec
University of Rochester —Rochester, NY
- $81,310 - $105,703 a year
- Full-time
- Nursing
- Medicine
- Surgery
Referrals Coordinator
Arroyo Vista Family Health Center —Los Angeles, CA
- $24.03 - $27.60 an hour
- Full-time
- Spanish
- Computer literacy
- English
- Adoption assistance
Quick Apply
UTILIZATION MANAGEMENT COORDINATOR I MSO
NORTH EAST MEDICAL SERVICES —Burlingame, CA
- $38 an hour
- Full-time
- Research
- Outpatient experience
- Children
- Health insurance
- Dental insurance
Temp Medical Management Personal Care Coordinator
Santa Clara Family Health Plan —San Jose, CA
- $66,273 - $99,409 a year
- Temporary
- Spanish
- Clean driving record
- Microsoft Outlook
UTILIZATION MANAGEMENT COORDINATOR II MSO
NORTH EAST MEDICAL SERVICES —Burlingame, CA
- $39.69 - $45.10 an hour
- Full-time
- Bachelor of Science
- Research
- Mid-level
- Health insurance
- Dental insurance
Utilization Management Clinical Specialist
I Am Boundless, Inc. —Worthington, OH
- $72,171 - $88,014 a year
- Full-time
- Background check
- Experience working with individuals with developmental disabilities
- Pass drug screening
- Continuing education credits
- Paid holidays
Quick Apply
Supportive Housing Specialist
Pioneer Human Services —Bellingham, WA
- $23.54 - $35.30 an hour
- Full-time
- Clean driving record
- Bachelor of Science
- Mid-level
- AD&D insurance
- Health insurance
Quick Apply
Utilization Management (UM) LVN Case Manager
CENTRIC HEALTHCARE SERVICES —Bakersfield, CA
- $30 - $34 an hour
- Full-time
- Customer service
- Mid-level
- Office
- Health insurance
- Dental insurance
Quick Apply
Onsite Physician Advisor - Texarkana
Christus Health —Texarkana, TX
- Full-time
- Hospital
- 5 years
- BC/BE
- Relocation assistance
Physician Advisor
Christus Health —Beaumont, TX
- Full-time
- Medicine
- Hospital
- 5 years
- Relocation assistance
4d
UM Medical Director - Family Medicine - Remote
Optum —Houston, TX
- $248,500 - $373,000 a year
- Full-time
- Remote
- Medicine
- Microsoft Outlook
- 5 years
Quick Apply

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Transportation Specialist I

Partnership HealthPlan of California -
Redding, CA

Apply Now

Job Details

Full-time
$28.52 - $33.51 an hour

Qualifications

Computer literacy
Employee relationship building
High school diploma or GED
Typing
Quality data entry
Customer data entry

Full Job Description

Overview:

To facilitate access to medical care by coordinating Non-Emergency Medical (NEMT) Transportation, Non-Medical Transportation (NMT) transportation and travel-related benefits for members. Coordinates care in collaboration with internal and external partners to help members overcome barriers to care created by lack of transportation.

Responsibilities:

Effectively communicate written and verbally with both members and providers.
Works directly with members, transportation providers and medical or social service facilities to coordinate appropriate level and timeliness of transports and travel-related services such as meals, lodging and flights within the DHCS guidelines and Partnership policies.
Support and assist members in the resolution of problems with their transportation or travel benefits. Investigates issues using critical thinking and resolves or escalates as necessary.
Uses customer service skills to manage member and provider complaints and file grievances or escalate as necessary.
Communicate immediate health issues to a clinical member of the Care Coordination team and assist as needed in problem resolution.
Communicate non-transportation related needs to the appropriate team for assistance.
Establish and maintain effective interpersonal relationships with all levels of health plan staff, other programs, agencies and the general public.
Verifies member’s eligibility and determines level of program benefit.
Verifies transportation drop-off/pick-up locations to ensure adherence with Medi-Cal guidelines and uses critical thinking skills to identify potential fraud, waste and abuse.
Elicit medical information from provider, consulting with HS/UM Clinical Staff as appropriate.
Contacts provider, verbally and/or in writing to pursue needed information necessary to determine appropriate level of care or authorizations.
Generates administrative denial letters timely as per Partnership Policy and Procedure
Validates member and driver information necessary to process gas mileage reimbursements
Documents all cases opened for Transportation in the appropriate platform or database, as
per protocol.
Routes calls as appropriate in a courteous and professional manner from the ACD phone line in the transportation call center.

Secondary Duties and Responsibilities

Serves as departmental back-up as directed by Manager/Director.
Participates in special projects and assignments as required
Working knowledge and understanding of health plan structure and program requirements.

Qualifications:

Education and Experience

High School diploma or equivalent required. One (1) year experience in the medical/clerical field; or equivalent combination of education and experience. Experience in phone based customer service.

Special Skills, Licenses and Certifications

Excellent oral communication with problem solving skills. General knowledge of managed care. Ability to work within an interdisciplinary team structure and function in a fast-paced environment while managing multiple priorities and meeting deadlines. Strong organizational skills required. Effective telephone and computer data entry skills required. Ability to access data and information using automated systems. Bilingual skills in Spanish, Tagalog, or Russian are preferred.

Performance Based Competencies

Excellent written and verbal communication skills. Ability to follow established procedures and protocol. Ability to communicate effectively with coworkers, physicians, and health care providers.

Work Environment And Physical Demands

Daily use of telephone and computer for most of the day. Standard cubicle work station with a shared common area. Ability to use a computer keyboard. Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs.

All HealthPlan employees are expected to:

Provide the highest possible level of service to clients;
Promote teamwork and cooperative effort among employees;
Maintain safe practices; and
Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

HIRING RANGE:

$28.52 - $33.51

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Apply Now

Refine Your Search

non clinical um specialist jobs

Transportation Specialist I

Clinical Specialist, Quality Management I

Quality Management Specialist

Payor Specialist- Weekends

Utilization Management Specialist

Provider Contract Specialist (Field Remote)

Intake Specialist- Hybrid-AZ

Utilization Specialist - Full Time

CSP Utilization Review Specialist/Quality Manager

Clinical Document Spec

Referrals Coordinator

UTILIZATION MANAGEMENT COORDINATOR I MSO

Temp Medical Management Personal Care Coordinator

UTILIZATION MANAGEMENT COORDINATOR II MSO

Utilization Management Clinical Specialist

Supportive Housing Specialist

Utilization Management (UM) LVN Case Manager

Onsite Physician Advisor - Texarkana

Physician Advisor

UM Medical Director - Family Medicine - Remote

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