Care Coordinator, Utilization Management

CVS Health•Work At Home-Illinois, IL

3d•$17 - $31•Remote

About The Position

The Care Coordinator, Utilization Management (UMCC III) plays a pivotal role in overseeing the day-to-day operations of the Utilization Management (UM) department. Operational expertise will drive process improvements, optimize workflows, and enhance the quality of care delivery within the Utilization Management Team. This role interacts with the UM physician reviewers, external payer partners, and vendors. The UMCC III will report to, and work alongside the Manager of Operations, Utilization Management.

Requirements

High School diploma or equivalent required
Minimum of 2 years of experience in utilization management, healthcare operations, or a similar role.
Excellent analytical, problem-solving, and decision-making skills.
Strong communication and interpersonal skills, with the ability to collaborate effectively across multidisciplinary teams.
Proficiency in utilization management software systems and Microsoft Office applications.
Proven organizational and detail-orientation skills.
US work authorization.
Someone who embodies being Oaky

Nice To Haves

Radiating positive energy
Assuming good intentions
Creating an unmatched patient experience
Driving clinical excellence
Taking ownership and delivering results
Being relentlessly determined

Responsibilities

Provide support overseeing operational aspects of the Utilization Management team’s activities.
Identify opportunities to streamline and optimize utilization management workflows, improve efficiency and reduce administrative burden.
Collaborate and effectively communicate with internal departments, external partners, and vendors.
Efficiently navigate between multiple electronic platforms.
Meet standard performance and quality metrics.
Other duties, as required and assigned.