Utilization Management Coordinator | ASAM Criteria Expert

Progressions; Philadelphia (Philadelphia County); On-site; USD 38,572 - 48,216; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Paid Time Off

401K plan with company match

Job summary

Progressions is hiring a full time Utilization Management Coordinator in Philadelphia. This position involves conducting continued stay reviews, ensuring compliance with medical necessity criteria, and collaborating with treatment teams.

The ideal candidate will possess a Master's degree or an accredited nursing qualification and have experience in utilization review. The role offers a supportive environment focused on professional growth and teamwork.

Qualifications

• Client-focused and team-oriented individual with flexibility to manage workload changes.
• Previous utilization review experience preferred.
• Knowledge of ASAM criteria and medical necessity criteria.

Responsibilities

• Conduct continued stay reviews of medical record documentation.
• Coordinate reviews, appeals, and maintain denial logs.
• Educate new staff members about ASAM criteria and documentation needs.

Skills

Interpersonal skills

Communication skills

Problem-solving skills

Compliance focus

Education

Master's Degree or accredited nursing program

Tools

Microsoft Office

Billing systems

Job description

Progressions is hiring a full time Utilization Management Coordinator in Philadelphia. This position involves conducting continued stay reviews, ensuring compliance with medical necessity criteria, and collaborating with treatment teams.

The ideal candidate will possess a Master's degree or an accredited nursing qualification and have experience in utilization review. The role offers a supportive environment focused on professional growth and teamwork.