Utilization Management Technician
Utilization Management Technician
Application Instructions:
Make sure your resume has been customized to the role described below showing you are a good fit for the role. Email your custom resume to [email protected]. If there is a job match, then I will email you a link to the application with further instruction.Must be able to work rotating holidays and weekends.
This position is 100% remote
The Utilization Management Tech functions under the direction of the Supervisor to coordinate, generate, and track both incoming and outgoing correspondence, faxes, and authorizations related to prospective, concurrent, and post-service review functions. Interacts with facilities, vendors, providers, and other staff to facilitate receipt of information and /or records for prompt review and response. Compensation plans for physicians, licensed nurse reviewers, staff, and consultants who conduct medical management do not contain incentives, directly or indirectly, that encourage barriers to care and service in making determinations.
Education/ Experience:
High School/GED required. Associate's Degree or equivalent education & experience preferred Minimum of 1 year of general office and/or customer service experience preferred Work experience in utilization management/review in a healthcare/MCO setting preferred Knowledge of medical terminology preferred Minimum of 1 year experience in Managed Care, Insurance, or Call Center preferred Proficiency with Microsoft Office Suite (Word, Excel, PowerPoint, OneNote) required Ability to work in a fast paced telephonic environmentOur Comprehensive Benefits
Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.
At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to hear you.
Headquartered in Newtown Square, Pennsylvania, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
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