Outpatient UM Coordinator

MedPOINT Management; Los Angeles (CA); Hybrid; USD 80,000 - 100,000; Full time

Benefits offered by this job

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

Job summary

MedPOINT Management is looking for an Outpatient UM Coordinator in Sherman Oaks, CA. The role involves reviewing outpatient treatment plans, coordinating with healthcare providers, and ensuring compliance with clinical guidelines. Candidates should have an active RN license or relevant certification and at least 2 years of related experience. Strong communication skills and proficiency in electronic health records are essential. This position offers flexible work from home options and a supportive environment that values professional growth.

Qualifications

• 2+ years of experience in outpatient utilization management or related field.
• Strong knowledge of medical terminology, insurance processes, and clinical guidelines.
• Proficient in EHR systems and Microsoft Office Suite.
• Detail-oriented with strong organizational and time-management skills.

Responsibilities

• Review outpatient treatment plans for medical necessity and compliance.
• Coordinate with healthcare providers for authorizations and care transitions.
• Utilize clinical guidelines to determine appropriate levels of care.
• Document and track authorization requests and outcomes.
• Communicate effectively with patients, providers, and insurance companies.
• Monitor outpatient utilization and quality metrics.

Skills

Medical terminology

Insurance processes

Clinical guidelines

Communication skills

Interpersonal skills

EHR systems

Microsoft Office Suite

Organizational skills

Time-management skills

Patient-centered care

Education

Active RN license or relevant clinical certification

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.