Outpatient UM Clinician

Job not on LinkedIn

🔥 2 hours ago

🏄 California – Remote

🏄 California – Remote

💵 $36 - $48 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

✨ Clinician

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MedPOINT Management

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1988

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

MedPOINT Management is a California-based healthcare management services organization that supports independent practice associations (IPAs), provider networks, hospitals and contracted health plans with clinical quality, care management, administrative operations and technology solutions. For more than 32 years MPM has provided services including provider network operations, case management, utilization management, claims operations, credentialing, HEDIS/STARs quality measurement and analytics (via Cozeva), call center and financial management, and digital provider portals and resource libraries. The company emphasizes data security and compliance (SOC 2 and HITRUST e1 certifications for its EZ-CAP and Provider Web Portals) and focuses on enabling value-based care, quality improvement, and operational support for providers and payers.

📋 Description

• Conduct utilization reviews for outpatient services to ensure compliance with standards. • Collaborate with healthcare providers to assess patient needs and treatment plans. • Document and track patient progress and treatment outcomes. • Communicate with insurance companies regarding authorizations and appeals. • Provide education and support to patients and families regarding care options. • Participate in quality improvement initiatives to enhance service delivery. • Stay updated on industry regulations and best practices in utilization management. • Assist in training and mentoring new staff on UM processes.

🎯 Requirements

• Licensed clinician with a background in nursing, social work, or a related field. • Minimum of 2 years of experience in utilization management or case management. • Strong understanding of healthcare regulations and insurance processes. • Excellent communication and interpersonal skills. • Ability to work collaboratively in a fast-paced environment. • Proficient in electronic health records and documentation practices. • Detail-oriented with strong analytical and problem-solving skills. • Commitment to patient-centered care and quality improvement.

🏖️ Benefits

• 401(k) • 401(k) matching • Company parties • Dental insurance • Employee discounts • Free food & snacks • Health insurance • Opportunity for advancement • Paid time off • Parental leave • Savings bank • Training & development • Vision insurance • Wellness resources