**It's more than a career, it's a calling.**

MO-REMOTE

**Worker Type:**

Regular

**Job Summary:**

Serves as the Utilization Management system-wide point of coordination between regional clinical and operational team leaders, physician liaisons, and revenue cycle leaders.

**Job Responsibilities and Requirements:**

PRIMARY RESPONSIBILITIES

+ Serves as the direct resource for the regional physician liaisons regarding Utilization Management (UM) initiatives and regional specific UM issues.
+ Performs audits on UM denial write off accounts to ensure accurate categorizing of the root cause of denial and to identify potential opportunities for claims re-bill.
+ Collaborates with Managed Care Organization (MCO) team members to stay abreast of contractual updates to develop and maintain UM payer grids with contractual requirements.
+ Serves as a UM subject matter expert on state and federal regulatory requirements r...