Most of the healthcare facilities hire a UM Coordinator for controlling service-improvement programs. A successful UM Coordinator Resume mentions the following core duties and responsibilities – monitoring the health and status of residents of patients within the facility to ensure that they are being cared for properly; training employees within the hospital to develop the right care plan, participating in inspections of the health care facility, making recommendations on how the nursing service department can be improved, and monitoring changes in federal and state health care laws and ensuring compliance.
Utilization management is crucial for any facility, and hence the professional coordinating this segment should possess certain complex skillset in the following forms – project management skills, the ability to make presentations, robust assessment, analytical and computer skills. This role requires a bachelor’s degree in social work, psychology, counseling, or a closely related field. In many cases, an associate’s degree in nursing and licenses are required.
Summary : Currently looking for a permanent part time Case Manager position. I am an excellent, experienced RN case manager, with over 20 years in the field. I have very good written and verbal communication skills. I will be an asset to your company/hospital as my specialty is assuring patient's receive the highest quality of care, always at the appropriate level, while ensuring appropriate use of resources.
Skills : Microsoft Word, Excel Certified, Insurance Verification, Obtaining Authorization, etcs .
Description :
Addressed questions or problems of staff, management and union in regards to Staffing and/or Payroll issues.
Worked with multiple offices, students, and faculty.
Oversaw curriculum management such as: updating course information, scheduling classrooms, ordering course evaluations, and assisting with course approvals, permissions, and waivers.
Helped students with paperwork related to program milestones, visa needs, and funding.
Maintained admissions data, reports, and statistics.
Helped with planning and organization of recruiting and social events for Robotics students and faculty.
Developed and documented policies, procedures, and best practices.
Experience
10+ Years
Level
Senior
Education
Diploma In General Education
UM Coordinator Resume
Headline : Currently looking for a permanent part time Case Manager position. An excellent, experienced RN case manager, with over 20 years in the field. I have very good written and verbal communication skills. I will be an asset to your company/hospital as my specialty is assuring patient's receive the highest quality of care, always at the appropriate level, while ensuring appropriate use of resources.
Skills : Excellent presentation and communication skills.<br>
Description :
Responded to student and faculty inquiries related to the Robotics undergraduate program.
Worked knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems.
Proficient utilized electronic medical record and documentation programs.
Proficient and/or experienced with medical terminology and/or ICD-10 codes.
Experienced with Utilization Review and/or Prior Authorization, preferably within a managed care organization.
Supplied Resident Room linens, wellness snacks and beverages, and lab coats.
Processed House Officer meal money for loading on to ID Badges.
Experience
5-7 Years
Level
Executive
Education
Diploma In General Education
UM Coordinator Resume
Summary : Have 12 years experience in the Utilization Management department and I am very familiar with medical terminology, ICD 9 codes, ICD 10 codes, CPT codes, and health plan compliance and turnaround times. In my position I have learned to adapt to difficult and high demand deadlines.
Skills : Customer service, Record maintenance, Time management.
Description :
Created evaluations in MedHub
Distributed evaluations and tracks completion.
Tracked conference attendance.
Gathered and distributed orientation materials.
Ran morbidity and mortality reports.
Monitored missing case log report.
Served as a secondary liaison between Program Director and residents/fellows.
Experience
7-10 Years
Level
Management
Education
High School Diploma
UM Coordinator Resume
Objective : Proficient in Microsoft Windows and Microsoft Office applications Proficient in Soarian, Meditech, Max mc, and Super search applications Excellent oral and written communication Competent self-starter and able to multi-task with competing priorities Team player and skilled at interacting professionally with others Capable of remaining calm under stressful conditions.
Skills : Microsoft, Coordinating Skills.
Description :
Accurately and effectively applied policies, benefit and eligibility policies, procedures and standards.
Requested assistance of supervisor or appropriately licensed health professional when necessary Reference CPT codes, ICD-9 codes and medical terminology.
Maintained confidentiality of all PHI in compliance with state and federal law and IEHP policies.
Accurately documented all activities as per policy including entry into automated system Meet established goals.
Routed cases to Registered Nurses for review as necessary.
Entered and documented prior authorizations into appropriate claims processing system based on information provided by medical groups Accomplishments I was very productive.
Able to work at home because exceeded my work expectations.
Experience
2-5 Years
Level
Junior
Education
Associate's
UM Coordinator Resume
Headline : UM Coordinator is responsible for Working with multiple offices, students, and faculty, Overseeing curriculum management such as: updating course information, scheduling classrooms, ordering course evaluations, and assisting with course approvals, permissions, and waivers, Helping students with paperwork related to program milestones, visa needs, and funding.
Skills : Computer Skills, Maintenance Skills, Team Member.
Description :
Input and processed referral authorization and request related data into Xpress system for referrals received via fax or electronically.
Verified eligibility, benefit issues and address other referral related services from providers and their office staff.
Authorized requests as appropriate within defined scope.
Screened all provider and member calls regarding utilization management, case management, denials, inpatients and physician reviewer line.
Sent denial letter to providers and members with a defined explanation of denial.
Sent referral notifications to providers and health plan.
Updated Inpatient list for physicians and management with patient status for discharge from hospital or assigned to hospice.
Experience
5-7 Years
Level
Executive
Education
MS
UM Coordinator Resume
Summary : As a UM Coordinator, responsible for the assessment, treatment planning, intervention, monitoring, evaluation and documentation on identified Special Needs Plan (SNP) members, responsible for daily phone calls to providers for medical records to assist Medical Director in determinations of authorizations.
Skills : Robust assessment, Analytical, and Computer skills.<br>
Description :
Daily eligibility and benefit checked with internal systems.
Daily entered and processed of referrals and authorizations into MHC and Corecon.
Generated and approved authorizations based on set business rules and compliance.
Reviewed with Medical Directors for outcomes on authorizations for compliance.
Requested and reviewed LOA's with contracting department when requested by providers.
Attended GME Program Administrator Education Series sessions.
Assisted residents/fellows with program questions using outstanding customer service.
Experience
7-10 Years
Level
Management
Education
High School Diploma
UM Coordinator Resume
Objective : UM Coordinator is responsible for Serving as backup for input of schedule into Med Hub and monitoring for accuracy, Assisting if needed with entry of call schedule into paging, Assigning parking to applicable structure/lot, and also Tracking vacations and conferences.
Skills : Tracking Skills, Monitoring Skills.
Description :
Calculated the daily staffing needs for each department.
Coordinated daily staffing of departments including replacement of personnel due to earned time off, leave of absence, personal time off, compassionate leave plus extra needs of each individual department according to special circumstances.
Processed all requests for time off, including ETO, LOA, PTO, ESL, etc.
Determined whether time off can be granted depending upon ability to replace and department guidelines.
Ensured the Staffing and Payroll Office staff adhere to all union agreements.
Assisted with the running of work hour compliance and submission reports.
Made resident/fellow travel arrangements.
Experience
0-2 Years
Level
Entry Level
Education
Diploma In General Education
UM Coordinator Resume
Headline : As a UM Coordinator, responsible for Responding to student and faculty inquiries related to the Robotics undergraduate program, Maintaining admissions data, reports, and statistics, Helping with planning and organization of recruiting and social events for Robotics students and faculty.
Logged and tracked Senior Expedited Organizational Determination Requests (stat referrals) and forwarded the monthly logs to the Health Plans.
Produced monthly reports for quality assurance, completed work according to Medicare guidelines.
Used Communication skills with healthcare providers: Doctors, Registered Nurses, LVNs, etc.
Knowledged of referral guidelines.
Managed members on an outpatient basis to assure the appropriate level-of-care is provided, to prevent in patient re-admissions and ensure that the members' medical, environmental and psychosocial needs are met over the continuum of care.
Notified the Department of sick leave accounts.
Directed authorizations to contracted providers whenever possible and authorize services at proper level.
Experience
5-7 Years
Level
Executive
Education
MS
UM Coordinator Resume
Headline : As a UM Coordinator, Working within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction, Following standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.
Skills : Leadership, Monitoring Skills.
Description :
Designed and implemented a new email system, following best practices in web design and implementation.
Troubleshoot and resolved issues with existing email systems.
Ensured compliance with email system policies.
Monitored trends in email usage and make changes to the email system accordingly.
Implemented new features to improve user experience and increase productivity.
Developed training modules for users of the email system.
Provided customer support to all users of the email system.
Experience
5-7 Years
Level
Executive
Education
Master Of Business Administration
UM Coordinator Resume
Summary : To obtain a position that will enable me to use my strong organizational skills; professional with over 15 years of experience working in the medical field. Excellent communication skills and proven track record of successfully managing heavy patient caseloads, eligibility verification, obtaining authorizations, patient registration, and customer service.
Skills : Training Skills, Medical Skills, Presentational Skills.
Description :
Communicated with other IT teams about issues that affect their work.
Coordinated student orientation activities including but not limited to developing and implementing programming for new students facilitating first-year transition programs and providing information on academic life at UM Ann Arbor.
Managed student organizations including but not.
Managed support for faculty through administrative tasks related to teaching.
Helped prepare class presentations, exams, syllabi, and other materials.
Maintained class content platform sites (Canvas).
Answered questions, locate and provide information, and resolve issues on behalf of faculty.
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