Healthcare Utilization Management Jobs

Title: Healthcare Utilization Management Coordinator

Location: Rockville, MD

Duration: 6 Months Contract

:

Term of Employment

• Contract, 6 Months
• This is 100% Remote Opportunity

Overview

• Our client is looking for a Utilization management Coordinator who can support the Utilization Management clinical teams by assisting with non-clinical administrative tasks and responsibilities related to pre-service, utilization review, care coordination and quality of care.

Responsibilities

• 20%: Provides general support and coordination services for the department including but not limited to answering and responding to telephone calls, taking messages, letters and correspondence, researching information and assisting in solving problems.
• 35%: Reviews authorization requests for initial determination and/or triages for clinical review and resolution.
• 35%: Performs member or provider related administrative support which may include benefit verification, authorization creation and management, claims inquiries and case documentation.
• 10%: Assists with reporting, data tracking, gathering, organization and dissemination of information such as Continuity of Care process and tracking of Peer to Peer reviews.

Required Skills & Experience

• High School Diploma.
• Ability to pay attention to the minute details of a project or task
• Microsoft Office applications such as Word, Excel, Outlook and Teams
• Excellent communication, organizational and customer service skills.
• 3 years experience in health care claims/service areas or office support.
• Knowledge of standardized processes and procedures for evaluating medical support operations business practices
• Excellent independent judgment and decision-making skills, consistently demonstrating tact and diplomacy.
• Ability to effectively participate in a multi-disciplinary team including internal and external participants
• Knowledge of basic medical terminology and concepts used in managed care.

Preferred Skills & Experience

• Knowledge of CPT and ICD-10 coding
• 2 years’ experience in health care/managed care setting or previous work experience within division.

Sincerely,

Preetam Raj

Lead Technical Recruiter

nTech Workforce Inc

D: 410-505-4857 EXT: 726

E: [email protected]

preetam(at)ntechworkforce(dot)com