UM Care Coordinator

Centers Plan for Healthy Living's goal is to create the ultimate healthcare experience that provides our members, their families, healthcare decision makers, and general caregivers with the guidance and plans they need for healthy living. Job Summary The Utilization Management Care Coordinator works within a multidisciplinary care team to assist with the care of members enrolled in our Managed Long Term Care program and facilitate authorization requests for eligible members. Primary Responsibilities Assists in the prior authorization of services and ongoing authorization requests Assists in completing authorization updates as needed based on the care plan of the member Coordinates with providers regarding authorization activitiesCoordinates communication between authorization clinical staff, members and providers as needed Acts as liaison and member advocate between the member/family, physicians and the care team to ensure timely and effective communication with regard to the member’s care Participates in case round meetings and ongoing education activities Ensures that all job responsibilities are carried out in compliance with CPHL and State and Federal regulations Other assigned duties Education And Experience Education Required: HS Diploma Preferred: Bachelor's Degree Type of Experience Required Strong written and verbal communication skills Computer proficiency Strong multi-tasking abilities Preferred Experience working within a managed care environment Specific Technical Skills Preferred: Computer proficiency in Microsoft Office applications Certifications/Licensure Required: None Physical Requirements Must be able to operate a computer and telephone Center Plan For Healthy Living is committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our employees and our business. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law and will not be denied employment. #J-18808-Ljbffr Centers Plan for Healthy Living