Myles A Campbell

Inpatient Coordinator @IEHP

Rancho Cucamonga, CA, US

Responsible for daily review of the daily census report in an effort to eliminate duplicates or other admission received from all contracted and non contracted facilities not required by the health plan.• Responsible for the approval of service requested within the Inpatient Coordinator scope as indicated by the Utilization Management Guide approved by the Utilization Management Subcommittee.• Responsible for obtaining member discharge dates through daily calls or memo submissions to contracted and non contracted facilities.• Responsible for meeting the performance measurement standards for productivity and accuracy as well as timely processing of inpatient authorizations, inpatient service requests, and discharges.• Responsible for ensuring that Members receive Home Health or Durable Medical Equipment (DME) items as ordered via phone call and documentation of call within the medical management system.• Communicate with providers/facilities in consultation with the Utilization Management Nurse, regarding authorizations, orders, and clinical reviews.• Assist and provide support to Management or Inpatient Clinical Team as requested.