AltaMed Health Services is a nonprofit healthcare organization serving diverse communities across Los Angeles and Orange counties. Its community health network provides primary medical care, dental services, and senior care through 46 locations, with a focus on accessible, high-quality treatment and whole-community well-being. AltaMed also helps people enroll in healthcare programs, supporting its mission to make quality healthcare more accessible to everyone.
Utilization Management Coordinator II - AltaMed (Hybrid, Commerce, CA)
AltaMed Health Services is hiring a hybrid Utilization Management Coordinator II in Commerce, California. The role manages outpatient and inpatient authorization workflows, resolves complex referral issues, and applies state and federal requirements.
Description
- Support the Medical Management department
- Process outpatient and inpatient referrals and authorizations promptly while following state and federal guidelines
- Investigate and troubleshoot referral and authorization problems
- Use independent judgment to resolve complex issues
Requirements
- High school diploma or equivalent is required
- At least two years of experience in a medical billing environment is required
- Experience with pre-authorizations and reimbursement rules for Medi-Cal, CCS, and other government programs is required
- Previous experience in utilization management and authorization-referral processing is required
- An MA or medical billing certificate is preferred
- Experience with an IPA or HMO is preferred
- Previous experience in a lead role is preferred
Benefits
- Medical, dental, and vision insurance
- 403(b) retirement savings plans with employer matching contributions
- Flexible Spending Accounts
- Commuter Flexible Spending
- Career advancement and development opportunities
- Paid time off and holidays
- Paid CME days
- Malpractice insurance and tail coverage
- Tuition reimbursement program
- Corporate employee discounts
- Employee referral bonus program
- Pet care insurance
- Discretionary bonuses or incentives may apply