Utilization Management Coordinator (Remote)

Job Description

Job Ttitle: Utilization Management Coordinator (Remote)

Company: LEARN Behavioral


Description: Overview:Learn Behavioral is a national organization made up of dedicated and caring individuals with the sole purpose of nurturing children with autism and special needs to lead resilient and fulfilling lives. We specialize in contemporary, evidence based applied behavior analysis to deliver personalized treatment plans, backed by 20 years of clinical insights. We are proud to be a part of each family’s journey and share in the experience of finding success for every child, and family, in our care. If you share a similar passion for nurturing and empowering the success of others, along with the opportunity to have an impact on the lives of others, we are eager to connect with you!The Utilization Management Coordinator is responsible for working in conjunction with the intake, scheduling, clinical, and finance teams in addition to helping clients understand their services mostly funded through private or public health care plans. The Utilization Management Coordinator requests and enters funding contracts into Central Reach (CR) and follows up as needed when errors or discrepancies arise with client funding.

• Full-time remote schedule
• Pay rate: $20.00/hr – $24.00/hr

Responsibilities:

• Work directly with families, clinical teams, internal staff and funding sources to secure and maintain funding for services for clients within the Utilization Management Coordinator’s assigned regions.
• Submit clinical reports, forms and other required documentation to funding sources at the commencement of services and as needed for continuation of client services.
• Performs periodic and pre-service insurance verifications to confirm ongoing eligibility for services and provide cost share information to clients. Follows up with families whose coverage has lapsed or changed.
• Explain benefits and cost sharing information (i.e., deductibles and copayments) to clients.
• Utilize Central Reach for data entry of client authorizations for funding of services provided by Learn providers.
• Utilizes monthly funding end reports to manage expiring authorizations and timely data entry of authorizations in Central Reach; notifies clinical teams of any missing or late items.
• Work in conjunction with internal departments and clients to update eligibility and coverage and resolve any funding related issues as needed.

Qualifications:

• High School Diploma required; Bachelor’s Degree preferred.
• 3+ years utilization management experience required.
• Behavioral healthcare experience required; ABA experience a plus!

We are looking for someone who demonstrates:

• Communication Proficiency
• Customer/Client Relationship Focused
• Business Acumen
• Cultural Alignment
• Technical Proficiency
• Ability to multitask and maintain thoroughness
• Thrive in a fast-paced environment
• Adaptable to change
• Positive approach to daily routine

LEARN Behavioral offers competitive compensation, a comprehensive benefits plan, including 401(k), personal time off, paid holidays, and tuition reimbursement.LEARN Behavioral is an Equal Opportunity Employer. Candidates must be presently eligible to work in the United States.

Salary: $20 – 24 per hour

Location: Madison, WI

Date: Fri, 17 Jan 2025 05:14:25 GMT


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