Utilization Management Technician - Weekends/off hours | Remote
Candidate MUST be available to work Sunday-Thursday (preferred) OR Tuesday-Saturday.
Shifts are 9am-5:30pm EST OR 10am-6:00pm EST
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.
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.
Education/ Experience:
High School/GED required.
Associates Degree or equivalent education & experience preferred
Minimum of 1 year of general office and/or customer service experience preferred
Work experience in utilization management/review in a healthcare/MCO setting preferred
Knowledge of medical terminology preferred
Minimum of 1 year experience in Managed Care, Insurance, or Call Center preferred
Proficiency with Microsoft Office Suite (Word, Excel, PowerPoint) required
Diversity, Equity, and Inclusion
At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
We keep our associates happy so they can focus on keeping our members healthy.
Our Comprehensive Benefits
Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.
Apply Now
Shifts are 9am-5:30pm EST OR 10am-6:00pm EST
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.
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.
Education/ Experience:
High School/GED required.
Associates Degree or equivalent education & experience preferred
Minimum of 1 year of general office and/or customer service experience preferred
Work experience in utilization management/review in a healthcare/MCO setting preferred
Knowledge of medical terminology preferred
Minimum of 1 year experience in Managed Care, Insurance, or Call Center preferred
Proficiency with Microsoft Office Suite (Word, Excel, PowerPoint) required
Diversity, Equity, and Inclusion
At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
We keep our associates happy so they can focus on keeping our members healthy.
Our Comprehensive Benefits
Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.
Apply Now