Bilingual Compliance UM Coordinator 3

Become a part of our caring community Become a part of our caring community The Compliance (UM) Coordinator 3 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations. The Compliance (UM) Coordinator 3 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Bilingual in English and Spanish with full professional proficiency; able to successfully pass required examinations. The Compliance (UM) Coordinator 3 collects and analyzes data daily, weekly, monthly, or as needed to assess outcome and operational metrics for the team and individuals. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related workstreams. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Assignments are varied and often complex, requiring independent judgment, critical thinking, and interpretation of guidelines to determine appropriate courses of action. Follows established guidelines, regulatory turnaround times, and procedures for processing QIO fast track appeals and expedited authorization requests. Use your skills to make an impact Required Qualifications 1 - 3 years of technical experience Proficient in Microsoft Word & Excel Strong attention to detail and accuracy Must be passionate about contr