Utilization Management Assistant jobs in United States
cer-icon
Apply on Employer Site
company-logo

HealthCheck360 · 1 day ago

Utilization Management Assistant

hc360 is a healthcare company focused on reducing medical costs and enhancing employee engagement. They are seeking a dedicated Utilization Management Assistant to handle first level calls in Utilization Review, evaluate certification requests, and coordinate with healthcare providers to ensure appropriate patient care.

FitnessHealth CareWellness

Responsibilities

Answer first level calls in Utilization Review for HealthCheck360 participants
Evaluate certification requests by reviewing the group specific requirements
Triage the call to determine if a Utilization Review Nurse is needed to complete the call
Review medical records, coordinate with healthcare providers, and ensure that patients receive appropriate, cost-effective care in accordance with clinical guidelines and insurance requirements

Qualification

CNALPNMedical AssistantPatient health supportCustomer ServiceCommunicationDetail Oriented

Required

CNA, LPN, or Medical Assistant preferred
Background in patient health support or care
1+ years of experience within this field

Preferred

Strong interpersonal skills to be able to connect with patients, doctors, internal team members, and providers
Friendly demeanor and understanding to be able to relay sensitive information to members
Accuracy and attention to detail when reviewing pre-certifications and plans

Benefits

Medical, Dental, Vision Insurance
Flex Spending or HSA
401(k) with company match
Profit-Sharing/Defined Contribution (1-year waiting period)
PTO/Paid Holidays
Company-paid ST and LT Disability
Maternity Leave/Parental Leave
Subsidized Parking
Company-paid Term Life/Accidental Death Insurance

Company

HealthCheck360

twittertwittertwitter
company-logo
Healthcheck360 specializes in wellness, health management, health risk assessments, employee benefits and health coaching services.