Utilization Management Support CoordinatorJob Description, Salary, Career Path, and Trends
A utilization management support coordinator is in charge of providing both coordination and support to the utilization management processes. This utilization management support coordinator will ensure the process runs smoothly within your business, and should oftentimes be required to provide support to the required team members. The utilization management support coordination is also required to help with reviews for the proper medical procedures and appropriate actions taken.
A utilization management support coordinator can be extremely beneficial and effective at increasing team efficiency. The utilization management support coordination position requires an employee with effective teamwork and communication skills as well as the necessary understanding of utilization management.
Sample job description
The utilization management support coordinator is responsible for providing support to the utilization management (UM) process. This includes assisting with reviews of medical necessity and appropriateness, providing education to members and providers, and working with internal and external stakeholders to ensure quality care. The incumbent will also develop and maintain tools and resources to support UM activities. [Your Company Name] is hiring experienced utilization management support coordinators to join our growing company.
Typical duties and responsibilities
Monitor the health and status of residents or patients within a facility to ensure that they are being cared for properly
Train employees within the hospital to develop the right care plan
Perform administrative duties such as monitoring the discharge process and ensuring that clinical documentation is done accurately
Participate in inspections of the health care facility
Make recommendations on how the nursing service department can be improved
Monitor changes in federal and state health care laws, and ensure compliance
Education and experience
This position requires a bachelor’s degree in social work, psychology, counseling, or a closely related field. In most cases, an associate or bachelor’s degree in nursing, and a passing score on the NCLEX-RN licensing exam, are required.
Required skills and qualifications
Strong project management skills
Excellent presentation and communication skills
Robust assessment, analytical, and computer skills
Develop and maintain tools and resources to facilitate the UM process
Provide education on the UM process, coverage, coding requirements, and medical necessity to members and providers
Assist with reviews of medical necessity and appropriateness
Work with internal and external stakeholders to ensure quality care
Average salary and compensation
The average salary for a utilization management support coordinator is $46,900 in the United States. Position salary will vary based on experience, education, company size, industry, and market.
Los Angeles, California
Minneapolis-St. Paul, Minnesota
New York City, New York
Typical work environment
The utilization management support coordinator will work in a call center or office environment. They will need to be able to work independently and have excellent communication skills. Hours are typically Monday-Friday 9am-5pm, but may vary depending on the needs of the company.
Many Utilization Management Support Coordinators work from 9 a.m. to 5 p.m. Monday through Friday in an office setting. However, some who work in facilities that run 24 hours a day could work other shifts.
Though no certifications are required to become a utilization management support coordinator, going above and beyond will showcase to your employee that you are willing to put in extra effort.
Health Utilization Management Certification. This is a certification in utilization management through the Utilization Review Accreditation Commission (URAC). Whether you are performing delegated or other review services, this certification validates your program approach as well as the inherent value you bring to your partner organization.
A bachelor’s degree in psychology, counseling, social work, or a related field is required for utilization management support coordinator positions. Sometimes, an associate or bachelor’s degree in nursing and a license to practice nursing is required. Depending on the type of facility to which you’re applying, work experience in that field is also preferred. Because utilization management support coordinators work on streamlining health care processes and making them more efficient, experience, and in-depth knowledge of those processes, as well as best practices regarding patient care, are also recommended.
The National Committee for Quality Assurance (NCQA) offers facilities accreditation in Utilization Management. URAC, formerly known as the Utilization Review Accreditation Commission, is a nonprofit organization that also offers utilization management accreditation to health care facilities. A utilization management support coordinator needs to be familiar with the processes for receiving these accreditations, as they will be a crucial part of obtaining and maintaining it for their employer. Utilization management professionals can also earn personal certifications in the field, such as Health Care Quality & Management (HCQM) Certification from the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP).
US, Bureau of Labor Statistics’ job outlook
SOC Code: 11-9111
Projected Employment in 2030
Projected 2020-2030 Percentage Shift
Projected 2020-2030 Numeric Shift
Since utilization management involves reviewing and making processes and patient care more efficient, it is always evolving. Industry analysts and thought leaders say one particular trend in the field that utilization management support coordinators should be aware of is the increasing role of the physician advisor. Physician advisors are doctors who can work inside or outside a health care facility, and they help decide whether specific procedures and services are medically necessary. Utilization management professionals have to work closely with physician advisors to coordinate patient care procedures.
Another trend in the utilization management field is the use of artificial intelligence (AI). Utilization management support coordinators are now using advanced analytics in their jobs. They’re looking at data regarding a patient’s entire medical history to tailor care plans to their specific cases and needs.
Sample interview questions
How have you assisted with reviews of medical necessity and appropriateness in the past?
What education or experience do you have in health utilization management?
What resources do you feel are necessary to support the UM process?
What would you say is your strongest skill when it comes to utilization management?
Why are you interested in working as a utilization management support coordinator?
Do you have any experience working in a call center or office environment? If so, please describe.
How would you deal with a situation where you received conflicting information from different stakeholders?
What do you think is the most important aspect of providing quality care?
What does utilization management mean to you?
In what ways can a utilization management support coordinator impact the culture of an organization?
What personal habits or values allow you to work well within a team environment?
Why is communication important in health care and how do you ensure all those involved are on the same page?
How would your former or current manager describe you?
What is your ideal work environment and why?
Utilization Management Support Coordinator Jobs in Ashburn
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