UM Coordinator - Utilization Management

Join to apply for the UM Coordinator - Utilization Management role at Penn State Health

Location:

Hershey Medical Center —
Hershey, PA

Work Type: Part Time
FTE: 0.50
Shift: Day
Hours: 8:00 a.m. – 4:30 p.m.
Recruiter Contact: Denisse M. Rosado

Under the direction of a Utilization Management Nurse or Specialist, the Utilization Management Coordinator supports the UM process by obtaining authorizations, reviewing clinical documentation in the EMR, and ensuring compliance with insurance payer requirements for reimbursement. This role requires a thorough understanding of health plan insurance criteria. Additionally, the coordinator must have clinical knowledge to assess diagnoses, current conditions, and previous treatments relevant to service approvals.

• High School Diploma or equivalent required.
• Experience in a healthcare setting, with familiarity in insurance processes, prior authorizations, and electronic medical records.
• Working knowledge of medical terminology, diagnoses, and treatments relevant to patient care.
• Proven ability to communicate effectively with insurance companies and other external stakeholders.

• Certified Medical Assistant (MA) or Licensed Practical Nurse (LPN).

Penn State Health offers exceptional opportunities to learn and grow, exposure to a wide patient population, and the ability to provide individualized, innovative, and specialized care to patients in the community.

• Medical, dental and vision with no waiting period;
  Total Rewards Program.
• Employee Wellness Programs, Fitness Discounts.
• Generous Paid Time Off, Personal Time, Paid Parental Leave.
• Retirement, Extended Illness Bank, Life Insurance, Identity Theft Protection.
• Competitive Pay, Tuition Reimbursement, PAWS UP employee recognition program.
• Support from HR Solution Center, Learning and Organizational Development, Virtual Benefits Orientation, Employee Exclusive Concierge Service.

Penn State Hershey Medical Center is Central Pennsylvania’s only Academic Medical Center, Level 1 Regional Adult and Pediatric Trauma Center, and Tertiary Care Provider. As a four-time Magnet-designated hospital, Hershey values the hard work and dedication that our employees exhibit every day. Through core values of Respect, Integrity, Teamwork, and Excellence, our team is committed to compassionate care for our diverse patient population, our community, and each other.

We promote continued professional development, specialty certification, continuing education, and career growth.

Penn State Health is an Equal Opportunity Employer and does not discriminate on the basis of any protected class including disability or veteran status. All individuals selected for a position will undergo a background check appropriate for the position’s responsibilities.

Non Bargained