Utilization Management Coordinator

The Utilization Management Coordinator at Astrana Health is responsible for a range of tasks including processing treatment authorization requests, verifying benefits, and maintaining communication with healthcare providers. This vital role ensures that all UM policies and procedures are upheld while facilitating timely referrals to meet health plan standards.

To be considered for the Utilization Management Coordinator position at Astrana Health, candidates should have a high school diploma or equivalent, alongside two years of experience in a managed care environment, preferably within an IPA or MSO. Knowledge of medical terminology and proficiency in Microsoft applications are also essential for success in this role.

At Astrana Health, we encourage professional development and career growth for our Utilization Management Coordinators. Our focus on innovation and a team-oriented environment provides numerous opportunities for continuous learning, training, and advancement within our healthcare management structure.

Utilization Management Coordinators at Astrana Health work in a hybrid environment. This means you’ll have the opportunity to work both from home and in our office located in Monterey Park, CA, allowing for flexibility while contributing to a dedicated team that focuses on improving patient outcomes.

Astrana Health stands out as a premier employer for Utilization Management Coordinators due to our commitment to innovation, patient-centered care, and teamwork. We empower our employees through technology, fostering a collaborative atmosphere that prioritizes both professional and personal growth.

A successful Utilization Management Coordinator at Astrana Health demonstrates strong organizational skills, attention to detail, and the ability to manage multiple tasks efficiently. A knack for excellent communication and problem-solving in a fast-paced environment is also key to thriving in this role.

The total compensation target pay range for the Utilization Management Coordinator role at Astrana Health ranges from $20 to $24 per hour. This reflects our national target range and indicates our dedication to offering competitive compensation that meets industry standards.

When discussing your experience with managed care processes in an interview for the Utilization Management Coordinator position, focus on specific instances where you've handled pre-authorizations, eligibility checks, or provider interactions. Highlight your understanding of the importance of compliance and efficient processing, and share any relevant metrics or outcomes that demonstrate your effectiveness in this area.

To effectively answer how you prioritize tasks, consider discussing your methodology for assessing urgency and importance. Share a specific example of a situation where you successfully managed multiple urgent referrals or tasks, emphasizing how you maintained organization and communication with team members to meet all deadlines.

In your response, emphasize your attention to detail and commitment to following established UM policies. You can mention strategies such as regular reviews of relevant guidelines, seeking clarity when in doubt, and collaborating with team members to uphold compliance and maintain high processing standards.

To effectively answer this question, briefly outline your approach to problem-solving in such scenarios. Discuss how you would verify information using available resources, contact relevant parties for clarification, and ensure proper documentation processes are followed to resolve issues while maintaining a patient-first mentality.

When answering, share specific experiences where you've interacted directly with healthcare providers, highlighting the importance of strong relationships for effective utilization management. Discuss any strategies you've used to foster communication and collaboration while addressing any challenges that arise.

In responding to this question, provide a concrete example of a busy day or period when you had to manage several responsibilities simultaneously. Highlight your approaches, such as organizing tasks by urgency, using technology tools, or collaborating with colleagues to ensure all tasks were completed accurately and on time.

Discuss your understanding of confidentiality and compliance regulations related to patient information, such as HIPAA. Share practices you employ in your current role (or prior roles), such as secure data handling, limited access measures, and consistent training on privacy policies, to showcase your commitment to keeping patient information secure.

Highlight your belief in the importance of teamwork by discussing experiences where collaboration led to improved outcomes. Share how you communicate with team members, support each other’s goals, and the impact this has had on the quality and timeliness of processed referrals in your role.

For this question, prepare a specific example where you've identified a bottleneck or inefficiency in a process that related to utilization management. Describe the steps you took to analyze the issue, implement a solution, and the positive outcomes that followed, ensuring to emphasize the skills and insights that may be beneficial at Astrana Health.

In your response, convey your understanding of Astrana Health’s mission in improving patient outcomes and how that resonates with your own professional goals. Highlight your enthusiasm for being part of a technology-driven team focused on innovation and quality care, emphasizing how your skills align with their objectives.