Evolent · 19 hours ago
Coordinator, Utilization Management
United States
Full-time
Remote
Entry Level
$20/hr - $20/hr
1+ years exp
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Responsibilities
Reviewing internal workflows and policies to determine if submitted requests require a prior authorization review or redirect as required.
Entering data into a proprietary system generating cases for both the medical and behavioral health reviewers. These requests may be submitted via fax, email, or provider portal.
Working directly with physician’s offices to obtain missing information required to submit a prior authorization request.
Submitting IT tickets to address barriers to generating cases for clinical review and following the ticket through to completion.
Addressing requests promptly and courteously, honoring commitments and displays persistence obtaining necessary information to address issues and problems.
Meeting established Utilization Management Intake Objective and Key Results.
Qualification
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Required
A high school diploma or GED is required.
1 – 3 years of experience in a Coordinator role either requesting or submitting prior authorization requests. Or relevant health care experience in claims or appeal & grievance is required.
Ability to read, write and speak the English language fluently with patients and providers.
Ability to adapt to fluctuating situations and perform work of a detailed nature, while avoiding errors.
Proficient using computer and Windows PC applications, which includes strong keyboard and navigation skills.
Team oriented, demonstrates a strong work ethic and committed to productivity.
Ability to sit for the majority of shift.
Demonstrated ability meeting established goals while balancing a workload and prioritizing assignments in a remote environment.
The ability to connect to router via an ethernet cord (will be supplied with equipment) is required - our inbound/outbound calls application does not function on Wi-Fi, 4G, 5G, LTE, or Satellite internet services.
High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router.
Benefits
Comprehensive benefits (including health insurance benefits)
Company
Evolent
Evolent partners with health plans and providers to achieve better outcomes for people with complex health conditions.
1001-5000 employees
H1B Sponsorship
Evolent has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2023 (11)
2022 (18)
2021 (22)
2020 (21)
Funding
Current Stage
Public CompanyTotal Funding
$1.03BKey Investors
TPG Growth
2023-12-05Post Ipo Debt· $350M
2022-08-11Post Ipo Equity· $125M
2021-10-15Post Ipo Equity· $42.5M
Leadership Team
Frank Williams
Co-Founder and Director, Board of Directors
Sarah Alexander
Market President
Recent News
2024-10-29
2024-10-11
Company data provided by crunchbase
