What are the responsibilities and job description for the UM Program Specialist position at Imperial Health Plan of California?
COMPANY INFORMATION:
Imperial Health Plan of California, Inc. is approved by California Department of Managed Health Care to offer full-service Medicare Advantage coverage, including a Medicare Advantage Prescription Drug plan, and a Chronic Condition Special needs plan over numerous counties in California. Through its affiliate, Imperial Insurance Companies, Imperial also offers Medicare Advantage plans in Texas, New Mexico, Utah, and Arizona.
The company's mission is to deliver valuable care so that members are healthy in body, mind, and spirit to achieve their inherent potential.
The company's vision is to deliver value based care that is clinically effective, sustainable, and achieves exceptional outcome. Please be sure to check our company website at https://imperialhealthholdings.com
JOB DUTIES:
Will support the UM Program and required regulatory deliverables for Imperial Health Plan/ Imperial Health Holdings Medical Group.
ESSENTIAL JOB FUNCTIONS:
1. UM Liaison with Delegated Health Plan contacts for delegated on-going reporting deliverables.
2. Develop policies and procedures, program plans and work plans.
3. Assist and compile requested documents for UM IHP/IHHMG regulatory audits.
4. Schedule meetings for UM projects and/or regulatory audits.
5. Take notes for UM Team meetings, create agendas and track status of UM projects.
6. Create reports and presentations for the quarterly Medical Services Committee.
7. Coordinate and maintain tracking for Annual UM Training (UM employees & physician reviewers).
8. Creates Providers and Members newsletters articles.
9. Acts as a resource to staff, providers and/or members for UM program information.
EDUCATION/EXPERIENCE:
· High school graduate or equivalent.
· Bachelor’s Degree or equivalent combination of education and technical experience can substitute in lieu of degree.
SKILLS/KNOWLEDGE/ABILITY:
· Excellent planning and organization skills to track competing internal/external priorities.
Job Type: Full-time
Pay: $69,499.11 - $83,697.85 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Employee discount
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Referral program
- Retirement plan
- Vision insurance
Application Question(s):
- Do you have UM and Compliance experience?
Ability to Commute:
- Pasadena, CA 91106 (Required)
Work Location: In person
Salary : $69,499 - $83,698