A background check, security clearance and drug screening are required for this role.
YesCare is an Equal Opportunity/Affirmative Action Employer. In compliance with federal and state employment opportunity laws, qualified applicants are considered for all positions without regard to race, gender, national origin, religion, age, sexual orientation, disability, Vietnam era veteran, or disabled Veteran status. EOE including Disability/Protected Veterans.
ResponsibilitiesBelow is a list of your responsibilities as a Utilization Management Coordinator with YesCare:
Confirms admissions with outside hospitals and notifies the Utilization Management Department of need to report justification for admissionMonitors hospitalized patient’s status and reports back to the Program Manager on site.Provides daily inpatient reports to the HSA and HSS at each institutionWorks with attending physician and the providers of the Utilization Management Department to arrange discharge planCoordinates with the hospital utilization nurse to expedite discharge and avoid excessive lengths of stayNotifies appropriate personnel of any hospitalization longer than five (5) daysResponsible for ensuring the monthly report is sent to each site and participates in Utilization Review with Clinical Director and other personnel as requiredProvides assistance in the development and implementation of Utilization Management Policies and ProceduresAssists in approval process of outside servicesAssists in data entryCommunicates denial of inpatient charge to providersAssists in negotiating charges and arrangements for outside servicesContinually seeks inventive methods for reducing outside services costsReviews forms for completeness and accuracyServes as resource to sites and providers for authorization numbersForwards daily inpatient case management abstracts to Corporate UMReviews requests for outpatient services, codes, and forwards to Corporate UM Medical DirectorPerforms monthly audit of Inpatient, ER and Outpatient Events Performs hospital review of complicated and extended stay casesProvides in-servicing of staff on areas of expertiseLiaison between Corporate UM, institution physician and off-site hospital staffComplies with all rules, directives, policies, procedures and protocols of client and YesCareAssumes additional duties as necessary.
YesCare Benefits (only applicable for full-time positions)
Health, Dental and Vision InsuranceLife and Disability InsuranceGenerous PTO plan401k with matching fundsEmployee Discount and Rewards ProgramTuition Assistance Continuing Education Reimbursement#LI-RC1
About YesCare Health Correctional healthcare is not just a job. It’s a calling.By choosing a career with YesCare, you are choosing the opportunity to truly make a difference in the health, well-being, and future of the patients you serve. We take pride in being a pioneer provider of correctional healthcare. As a YesCare professional, you have access to the resources and support to enhance your skills, build a solid foundation to reach your career potential, and contribute to the care and well-being of an underserved population. There is no greater calling. Join YesCare today and be part of our legacy of innovation and clinical expertise.
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