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.
Internal candidates are welcome to apply; however, FT associates are not eligible to work both FT and Per Diem concurrently.
High School Diploma or GED required.
Minimum 1 year of experience in an customer service or medical office position required, preferably in a managed care organization.
Knowledge of medical terminology required.
Proficiency with Microsoft Office Suite (Word, Excel, Power Point). Comfortable working within a Windows based environment. Familiarity with electronic medical record and documentation programs.
Ability to attend a minimum of 2 weeks of in classroom (virtual) training as well as 2 weeks of a preceptorship in the office (40 hours a week).
Must provide 30 hours of availability to work a month; maximum number of hours per week is 15 to 18, based on the needs of the business.
There is no guarantee of hours to be scheduled to work and this position is not eligible for benefits.
Amerihealth Caritas Health Plan