Utilization Management Referral Specialist

MHM Services, Inc. Nashville , TN 37201

Posted 3 months ago

Overview

Centurion is proud to be the provider of medical services a to the Tennessee Department of Correction.

We are currently seeking a full-time Utilization Management Referral Specialist to join our Tennessee Regional Office Team in Nashville, Tennessee.

Available Shift

Monday- Friday; Days

Responsibilities

The Utilization Management (UM) Referral Specialist assists the UM Nurses in completing authorization reviews of specialty services/diagnostics requests, initiating the processing of authorization requests for outpatient and inpatient services, and routing the cases to the appropriate staff. This will include verifying patient eligibility of services and investigating when a patient's eligibility is in question. Additional responsibilities include answering phone queues, processing faxes, coordinating information between UM Nurses and centralized or site scheduling staff, and collating daily/monthly reports for the Statewide Medical Directors, UM Nurses, and operation leadership, as requested.

Benefits

We offer excellent compensation and comprehensive benefits for our full-time team members including:

  • Health, dental, vision, disability and life insurance

  • 401(k) with company match

  • Generous paid time off

  • Paid holidays

  • Flexible Spending Account

  • Continuing Education benefits

  • Much more...

About Us

Centurion contracts with state and local governments nationwide to provide comprehensive healthcare services to correctional facilities, state hospitals, and other community settings. Our dedication to making a difference and our passionate team of the best and the brightest healthcare employees has made us one of the leaders of the correctional health industry. Whether you are driven by purpose and impact or on a journey of professional growth, our opportunities can offer both.

Qualifications

  • High School Diploma or equivalent; some college preferred

  • Two (2) years of experience providing administrative support or customer service

  • Excellent telephone skills

  • Experience on customer call line or in team/call center environment

  • Knowledge of medical terminology strongly preferred

  • Must be able to pass background investigation and obtain agency security clearance

. indmhm ZR19


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Utilization Management Referral Specialist

MHM Services, Inc.