Clinical Resource & Utilization Coordinator

Hartford HealthCare; Wethersfield (CT); On-site; USD 50,000 - 70,000; Full time

Job summary

Hartford HealthCare in Connecticut seeks a Clinical Resource Management Associate to join the Care Management team. The role focuses on providing support and coordination of utilization management services for the Utilization Management department.

Responsibilities include monitoring EPIC queues, updating authorizations/denials, assisting with denials and appeals, triaging calls, and coordinating with payers and departments.

Qualifications

• High School Diploma required; Medical Administrative Assistant certification preferred.
• Two+ years professional experience in health care, managed care, or insurance.
• Strong interpersonal and communication skills.
• Effective time management in a fast-paced environment with changing priorities.
• High level understanding of confidentiality and HIPAA requirements.

Responsibilities

• Monitors and manages utilization management reports (Payer End of Day, UM list, Discharge Log, Discharge Disposition).
• Monitors and manages EPIC work queues and updates EPIC with authorization/denial information.
• Supports the Clinical Resource Management Nurse with denials, appeals, and physician advisor communication.
• Triages and routes department calls, voicemails, faxes, and secure messages.
• Communicates with payers, case management, medical records, and other departments; scans/documentation in EHRs.

Skills

Interpersonal skills

Time management

Organizational skills

HIPAA knowledge

Education

High School Diploma

Medical Administrative Assistant certification

Tools

EPIC

Job description

Hartford HealthCare in Connecticut seeks a Clinical Resource Management Associate to join the Care Management team. The role focuses on providing support and coordination of utilization management services for the Utilization Management department.

Responsibilities include monitoring EPIC queues, updating authorizations/denials, assisting with denials and appeals, triaging calls, and coordinating with payers and departments.