Our team members are the heart of what makes us better.
At Hackensack Meridian Health we help our patients live better, healthier lives – and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community.
Together, we keep getting better – advancing our mission to transform healthcare and serve as a leader of positive change.
The Utilization Management Coordinator coordinates and monitors daily activities of the utilization management functions of the Care Coordination Department, ensuring the appropriate allocation of hospital resources while maintaining quality of patient care. This position also holds the responsibility for ensuring regulatory compliance requirements and coordinating the medical management aspects of clinical review requests from external entities. The Utilization Management Coordinator serves as a functional expert and liaison to Care Coordinator Staff and other departments within the hospital system. The UM Coordinator assists to develop consistent processes and enhance workflow of the concurrent review process with third party payers. The UM Coordinator oversees and facilitates medical necessity appeals as the result of concurrent denials. The UM Coordinator functions as the PRO Liaison facilitating the review process for Hospital Issued Notices of Non-Coverage (HINN’s) and discharge reviews as they relate to Care Coordinator activities and directing PRO correspondence and cost outliers to the appropriate internal department. Provides Care Coordination Support as needed.
Responsibilities
A day in the life of a Utilization Management Coordinator at Hackensack Meridian Health includes:
Qualifications
Education, Knowledge, Skills and Abilities Required:
Education, Knowledge, Skills and Abilities Preferred:
Licenses and Certifications Required:
If you feel that the above description speaks directly to your strengths and capabilities, then please apply today!
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