Performs Precertification/certification/ authorization activities as part of the daily operations of the Utilization Management program at Memorial Hospital and Manor (MHM) within the Clinical Effectiveness model. These duties include but are not limited to: initial certification, collection of necessary information to initiate and/or complete authorizations as required by assignment/procedure, regulatory compliance, related denial management issues, and associated tracking/reporting efforts. This position serves as a liaison between MHM Medical staff and personnel, and third party payers. This position reports directly to the PAS Manager.
High School Diploma or equivalent is required. Associate degree preferred. Excellent organizational and communication skills with multi use computer skills required. Ability to work independently and meet deadlines is required.
A minimum of 2 years proven work experience required. Utilization manage and/or healthcare experience preferred but not required.