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Utilization Management (UM) Specialist

Company: Kforce Finance and Accounting
Location: Clearwater
Posted on: January 15, 2021

Job Description:

RESPONSIBILITIES:Kforce has a client in search of a Utilization Management (UM) Specialist in Clearwater, FL. Key Responsibilities: * Review, authorize or reject provider incidental requests consistent with program requirements and guidelines* Review applications and data entry fields for accuracy and completeness to store and process requests* Document, monitor, track and report incidental request decisions using electronic and manual systems and formats* Serve as the liaison between and community providers to assure effective coordination of services, assuring providers following contract requirements and Manual* Provide technical assistance and training to providers to ensure program services are conducted according to established standards and contractual agreements* Conduct prospective and concurrent review of provider incidental requests for completeness and accuracy, ensure requests meet program requirements, and include supportive documentation* Collaborate with Information Technology unit, fiscal unit and research teams to ensure data is tracked, reviewed and reported accurately and address any areas identified for process improvement* Assist with the preparation of tables, charts, reports and graphs for presentations on referrals, service utilization, and other topics as requested.* Participate in community meetings as needed.* Performs related work as assigned or required.Job Requirements:REQUIREMENTS:* Associate's degree in Human Services, Education, Case Management, Social Services, Non-Profit Management, Behavioral Health, Business, or related field* Minimum of three years of social service and/or utilization management, case management, patient advocacy, care coordination, client relations, customer service or a combination* Ability to perform system queries and organize and analyze information for reporting purposes* Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community* Skilled at using computer applications including Microsoft Access, Word, Excel and PowerPoint* Detail oriented and solution focused* Ability to work remotelyKforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.SDL2017

Keywords: Kforce Finance and Accounting, Clearwater , Utilization Management (UM) Specialist, Executive , Clearwater, Florida

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