Outpatient UM Coordinator

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.