About This Role
Hey there. I'm putting together the listing for this Utilization Management Technician consulting role, and I wanted to write it out myself. The details come straight from the hiring team.
What you'd be doing
You'd handle the full range of authorization requests: urgent, routine, pre service, and retro. It's about processing these requests accurately and getting them done promptly.
A big part of the day is working in different business applications. You'll analyze cases, gather what you need, and enter all the prior authorization data so claims can be adjudicated properly. You're going to use your judgment here; spotting missing information and making determinations based on clinical protocols is central to the job.
- Manage all types of authorization requests with accuracy and timeliness.
- Use various software systems for analysis, information gathering, and data entry related to prior authorizations.
- Apply critical thinking to identify gaps in information and make processing decisions following clinical guidelines.
- Interact with internal teams and external contacts to exchange information and maintain a high standard of service.
- Work alongside other healthcare professionals as part of the care delivery process.
- Make sure everything stays compliant with federal and state regulations for utilization management.
- Stay current on trends and changes in the healthcare field.
The background we need
We're looking for someone who's been doing this kind of work for a while. You'll need at least five years of experience in a similar role within healthcare.
- A Bachelor's degree in a healthcare related field is required. A Master's degree would be a plus.
- You have to be proficient with EPIC software and have experience with retro authorizations; that part's mandatory.
- A solid grasp of medical terminology, coding, and billing is essential.
- Your critical thinking skills are sharp; you can make sound decisions based on protocols and guidelines.
- You communicate well, both in writing and when talking to people inside or outside the organization.
- You've shown you can deliver high quality service consistently.
- The environment moves quickly, so handling multiple tasks at once is just part of it.
- Strong computer skills are a must; think Microsoft Office Suite and other common business applications.
- A deep understanding of the federal and state laws governing utilization management is important.
The schedule & pay
This is an hourly consulting position based in Manhattan, NY. The pay range is $21 to $25 per hour. Specific daily hours aren't listed in the original details provided to me.
A bit about what they offer
The benefits package is designed around supporting your well being and professional growth. Here’s what they highlighted:
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- They offer comprehensive health plan options that include medical, dental, and vision coverage.
- There are flexible spending accounts available to help offset medical costs.
- Retirement plans are part of the package to help with long term financial security.
- After two years of employment, you or an immediate family member qualify for free tuition.
- You get paid time off for vacation.
- There's also unpaid time off available for personal health needs or family care.
- Well being programs provide resources for physical, mental, and spiritual health.
- Employee discounts are offered on things like sports tickets, gym memberships, event tickets, etc.
- For professional development, there are training programs and resources aimed at growth.
How to apply & disclaimer
Job Location
Manhattan, NY