Outpatient UM Coordinator

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Job Description

Benefits: 401(k) 401(k) matching Company parties Dental insurance Free food & snacks Health insurance Paid time off Parental leave Savings bank Training & development Vision insurance Wellness resources About the Role: Join MedPOINT Management as an Outpatient UM Coordinator in Sherman Oaks, CA, where you'll play a crucial role in ensuring the quality and efficiency of outpatient care. This position offers a dynamic environment where you can make a real impact on patient outcomes and collaborate with a passionate team. Responsibilities: Review and assess outpatient treatment plans for medical necessity and compliance. Coordinate with healthcare providers to facilitate timely authorizations and care transitions. Utilize clinical guidelines and criteria to determine appropriate levels of care. Document and track authorization requests and outcomes in the system. Communicate effectively with patients, providers, and insurance companies. Participate in interdisciplinary meetings to discuss patient care and service improvements. Monitor and report on trends in outpatient utilization and quality metrics. Stay updated on regulatory changes and best practices in utilization management. Requirements: Active RN license or relevant clinical certification required. Minimum of 2 years of experience in outpatient utilization management or related field. Strong knowledge of medical terminology, insurance processes, and clinical guidelines. Excellent communication and interpersonal skills to collaborate with diverse teams. Proficient in electronic health record (EHR) systems and Microsoft Office Suite. Detail-oriented with strong organizational and time-management skills. Ability to work independently and manage multiple priorities effectively. Commitment to patient-centered care and continuous improvement. About Us: MedPOINT Management has been a trusted partner in healthcare management for over 15 years, dedicated to optimizing patient care and operational efficiency. Our clients appreciate our commitment to quality, while our employees thrive in a supportive and innovative work environment that values professional growth and collaboration. Flexible work from home options available.