Coordinator, UM Intake

Evolent

6d•Remote

About The Position

The Coordinator, Intake Utilization Management at Evolent will serve as a point of contact for processing prior authorization requests in accordance with departmental policies, regulatory requirements, and client contractual agreements.

Requirements

A high school diploma or GED - 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. Required
Ability to read, write, and speak the English language fluently with patients and providers. - Required
Ability to adapt to fluctuating situations and perform work of a detailed nature, while avoiding errors. - Required
Proficient in using computer and Windows PC applications, which includes strong keyboard and navigation skills. - Required
Team-oriented demonstrates a strong work ethic and is committed to productivity. - Required
Demonstrated ability to meet established goals while balancing a workload and prioritizing assignments in a remote environment. - Required
High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router.

Nice To Haves

Previous background/experience with Oncology.

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 generates 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 in obtaining necessary information to address issues and problems.
Meeting established Utilization Management Intake Objectives and Key Results.