AmeriHealth Caritas
Utilization Management Technician,
AmeriHealth Caritas, Broomall, Pennsylvania, United States, 19008
Join AmeriHealth Caritas
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 nation's 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 from 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. 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. Associate's 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. 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.
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 nation's 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 from 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. 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. Associate's 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. 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.