Health Services Authorisation Coordinator II

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Qhov chaw: Mariposa County, California; Merced County, California; Monterey County, California; San Benito County, California; Lub Nroog Santa Cruz, California

This opportunity is available for current Alliance regular and temporary Health Services Authorizations Coordinator I or II's and ECM Care Coordinators.

There are thirteen positions available.

Accepting applications through Monday, March 17, 2025 by 5:00pm.

We have an opportunity as a Health Services Authorization Coordinator II in the Utilization Management Department. 

KOJ YUAV TSUM TAU TXAIS RAU

Reporting to the Utilization Management Manager of Authorizations this position: 

• Processes basic to complex incoming treatment and referral authorization requests and verifies member plan eligibility
• Performs complex research on member authorization requests

LUB IDEAL CANDIDATE 

• Has one year of experience working for The Alliance as a Health Services Authorization Coordinator I los yog any experience working as a Health Services Authorization Coordinator II or Enhanced Care Management Care Coordinator.
• Has strong interpersonal skills to provide excellent customer service and process authorization requests accurately and timely
• Has the ability to work in a team-orientated environment and interact with others showing respect and understanding
• Achievement-driven and highly responsible, with the ability to manage complex authorizations and review requests for approval with precision and efficiency.

YUAV UA LI CAS YUAV UA LI CAS

Nyeem tag nrho cov lus piav qhia txoj haujlwm, thiab cov npe ntawm cov kev xav tau nias ntawm no.

• Kev paub txog:
• Medical terminology or billing code procedures
• Principles and best practices of customer service
• Standard business office practices and equipment
• Muaj peev xwm:
  • Txheeb xyuas cov ntaub ntawv tsim nyog siv ntau qhov chaw koom haum
  • Txhais, piav qhia thiab siv cov txheej txheem, cov cai thiab cov txheej txheem
  • Conduct research related to authorization limits and authorization requests
  • Pay close attention to detail and utilize effective organizational skills 
  • Produce and maintain accurate records 
• Kev Kawm thiab Kev Paub:
  • High School Diploma los yog sib npaug
  • A minimum of three years of experience in the health care field, including a minimum of one year of experience performing health services authorization coordination duties
  • An Associate’s degree may substitute for one year of general health care experience, or an equivalent combination of education and experience may be qualifying.

Lwm yam ntaub ntawv

• Peb nyob hauv ib puag ncig kev ua haujlwm hybrid thiab peb cia siab tias cov txheej txheem sib tham yuav tshwm sim nyob deb ntawm Microsoft Teams.
• Txawm hais tias qee tus neeg ua haujlwm tuaj yeem ua haujlwm puv sijhawm hauv xov tooj, yuav tsum tuaj koom ntawm cov xwm txheej thoob plaws lub tuam txhab peb lub hlis twg lossis cov rooj sib tham hauv chav haujlwm.
• Hauv chaw ua haujlwm lossis hauv zej zog tuaj yeem xav tau rau qee txoj haujlwm thiab nyob ntawm kev xav tau kev lag luam. Cov ntsiab lus hais txog qhov no tuaj yeem txheeb xyuas thaum lub sijhawm xam phaj.

Cov nyiaj them tag nrho rau txoj haujlwm no yog teev los ntawm qhov chaw hauv qab no. 

Qhov nyiaj them tiag tiag rau lub luag haujlwm no yuav raug txiav txim siab los ntawm peb qhov kev them nyiaj lub tswv yim, kev tshuaj xyuas ntawm tus neeg sib tw xaiv qhov kev tsim nyog (kev ncaj ncees lossis kev hloov pauv tau hais txog txoj haujlwm, kev kawm lossis kev cob qhia), nrog rau lwm yam (kev ncaj ncees sab hauv, kev ua lag luam, thiab thaj chaw nyob. ).

Apply for Health Services Authorization Coordinator II