Utilization Management Technician- Part Time

Amerihealth Caritas•,

1d•Remote

About The Position

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement. Your career starts now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nations 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. Discover more about us at www.amerihealthcaritas.com.

Requirements

High School/GED required.
Minimum of 1 year general office and/or customer service experience required
Work experience in healthcare setting required
Knowledge of medical terminology required
Minimum of 1 year experience in Managed Care, Insurance, or Call Center experience required
Proficiency with Microsoft Office Suite (Word, Excel, PowerPoint) required.
Consistent word processing speed and accuracy of 50 or more words per minute required
Must live in EST or CST time zones

Nice To Haves

Associate’s Degree or equivalent education & experience preferred

Responsibilities

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.