SilverSpringRecruiter Since 2001
the smart solution for Silver Spring jobs

Coordinator, Correspondence Compliance

Company: Kaiser Permanente
Location: Hyattsville
Posted on: September 22, 2022

Job Description:

The Correspondence Compliance Coordinator is responsible for the generation of UM required written notices to Kaiser Permanente members and providers. This position consistently supports compliance and Kaiser Permanentes Code of Conduct by adhering to federal, state, local laws and regulations, accreditation licensure requirements and Kaiser Permanentes policies and procedures.

Essential Responsibilities:

+ Reviews UM required written notices based on members jurisdiction and product line following regulatory requirements and UM policies and procedures.

Rotating weekends

Basic Qualifications:

Experience

+ Two (2) years of utilization review experience required.

+ Two (2) years of clinical experience required.

+ Two (2) years of experience working with computer system applications required.

Education

+ Bachelors Degree OR four years of directly related utilization review experience required.

+ High School Diploma or General Education Development (GED) required.

License, Certification, Registration

+ This job requires credentials from multiple states. Credentials from the primary work state are required before hire. Additional Credentials from the secondary work state(s) are required post hire.

+ Registered Nurse License (District of Columbia) within 6 months of hire

+ Registered Nurse License (Virginia) within 6 months of hire AND Registered Nurse License (Maryland) within 6 months of hire

OR

+ Compact License: Registered Nurse within 6 months of hire

Additional Requirements:

+ Extensive knowledge of NCQA, Medicare and state regulatory UM denial requirements.

+ Proficiency in the use of applicable computer software.

Preferred Qualifications:

+ Recent acute care, case management, or home health experience preferred.

+ Demonstrated ability to effectively and clearly present information through the written word, to influence or persuade others through oral presentation in positive or negative circumstances, and to listen well.

+ Demonstrated ability to write clearly, legibly, and effectively, to present ideas and document activities, to read and interpret written information.

+ Knowledge of managed care preferred.

COMPANY: KAISER

TITLE: Coordinator, Correspondence Compliance

LOCATION: Hyattsville, Maryland

REQNUMBER: 1092511

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.

Keywords: Kaiser Permanente, Silver Spring , Coordinator, Correspondence Compliance, Other , Hyattsville, Maryland

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Log In or Create An Account

Get the latest Maryland jobs by following @recnetMD on Twitter!

Silver Spring RSS job feeds