Utilization Management Coordinator

Job not on LinkedIn

🔥 16 hours ago

🌪️ Oklahoma – Remote

🌪️ Oklahoma – Remote

⏱ Part Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Saint Francis Health System

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1960

🏥 Healthcare

🏨 Hospitality

🤝 Non-profit

Healthcare • Hospitality • Non-profit

Saint Francis Health System is a healthcare organization based in Tulsa, Oklahoma that operates multiple hospitals, clinics, specialty centers, and support services across eastern Oklahoma. It offers a broad range of clinical services including primary care, cardiology and heart & vascular services, cancer care, neurosciences, behavioral and mental health, orthopedic care, women’s and pediatric care, imaging & lab services, rehabilitation, hospice and home care, trauma services, and specialty institutes (e. g. , Heart and Vascular Institute, Trauma Institute, Children’s Hospital). The system provides urgent care, virtual urgent care, in-home urgent care via DispatchHealth, emergency care including a pediatric emergency center, and many outpatient clinics and diagnostic services. It also supports physician services, medical education (OSU residency partnership), community outreach, financial assistance, patient billing/price transparency, charitable giving, and volunteer programs. The organization lists locations, patient resources, MyChart patient portal, and administrative functions (careers, supplier info, privacy and compliance notices).

📋 Description

• Provide administrative and clinical support throughout patient reviews, placement in levels of care, receipt of necessary services, and discharge planning • Participate in treatment teams and communicate reimbursement issues to providers • Participate in the Patient Care Committee for patient care reviews • Participate in the Utilization Review Staff Committee, provide data, and contribute to internal process improvement • Provide staff education as needed to support utilization review goals • Meet review interval requirements and supply clinical information to obtain authorization • Respond to authorizing entities' requests for additional detail • Provide eligibility, benefits, and level-of-care criteria information to treatment teams and Patient Care Committees • Seek treatment information for authorization reviews and contribute to discharge planning • Participate in quality-of-care process improvement and identify and report QI triggers • Review patient eligibility and benefits and match level-of-care utilization • Ensure compliance with managed care behavioral health standards for utilization management procedures and documentation • Investigate and prepare insurance appeals related to medical necessity or treatment issues • Participate in ongoing utilization management and UR Staff Committee process improvement goals

🎯 Requirements

• Completed the basic professional curricula of a school of nursing approved and verified by a state board of nursing, with a diploma or degree, OR Master's degree in Social Work, Counseling, or a related behavioral health field • Valid multi-state or State of Oklahoma Registered Nurse License, or LCSW, LPC, or LMFT license • 3–4 years of related experience in behavioral health care, including possible behavioral health managed care experience • Working knowledge of Microsoft Word, Excel, and Access • Effective interpersonal, written, and oral communication skills • Ability to analyze data to discover facts or develop knowledge, concepts, or interpretations • Ability to organize and prioritize work effectively and efficiently • Detail-oriented ability when examining numerical data • Ability to synthesize clinical case data into concise summaries

🏖️ Benefits

• Part-time ECB status with a minimum number of worked hours per month as needed by the department • Limited benefit offerings