Utilization Management Technician Sr

Amerihealth Caritas • ,

4d

About The Position

The Utilization Management Technician Sr. works under the direction of the Supervisor to coordinate, generate, and track incoming and outgoing correspondence, faxes, and authorizations related to prospective, concurrent, and post-service review functions. The role interacts with facilities, vendors, providers, and other staff to facilitate the receipt of information and records for prompt review and response.

The position assists the Supervisor with daily operations, trains and mentors new and existing associates using UM departmental training guides and tools, and may participate in workflow development, training, and implementation for UM Technician associates. The technician performs and stays knowledgeable about workflow and timeliness requirements across all areas of Utilization Management, and may perform other non-clinical duties as assigned by the UM Supervisor.

Requirements

• High school diploma required.
• 3–5 years of UM Technician, medical office, and/or managed care experience.
• Valid driver’s license and car insurance.
• Proficiency with Microsoft Office Suite, including Word, Excel, and PowerPoint.
• Consistent word-processing speed and accuracy of 50 or more words per minute.
• Proven proficiency in the UM Technician role and expertise with a medical management data system.

Nice To Haves

• Medical terminology highly recommended.
• Behavioral health experience is a plus.
• Call center, provider services, previous insurance, or hospital experience preferred.

Responsibilities

• Coordinate, generate, and track incoming and outgoing correspondence, faxes, and authorizations related to prospective, concurrent, and post-service review functions.
• Interact with facilities, vendors, providers, and other staff to facilitate receipt of information and records for prompt review and response.
• Assist the Supervisor with daily operation of the assigned area.
• Train and mentor new and existing associates using UM departmental training guides and tools.
• May participate in workflow development, training, and implementation for UM Technician associates.
• Perform and remain knowledgeable in workflow and timeliness requirements for all areas in Utilization Management.
• Perform non-clinical duties outside the standard UM Technician role as assigned by the UM Supervisor.

Benefits

• Flexible work solutions, including remote options and hybrid work schedules.
• Competitive pay.
• Paid time off, including holidays and volunteer events.
• Health insurance coverage for the employee and dependents on Day 1.
• 401(k).
• Tuition reimbursement.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: High school or GED