Utilization Management Assistant

Job Description

Job Description

Utilization Management Assistant

Location : Onsite in Dubuque, IA. Also accepting remote applicants.

Are you passionate about patient care and thrive in a fast-paced, professional environment? We are seeking a dedicated Utilization Management Assistant to join our healthcare team. This role is ideal for CNAs, Medical Assistants, LPNs, or individuals with a background in patient health support who are looking to make a meaningful impact behind the scenes. If you are looking to get into a professional office setting with daytime office hours and weekends / holidays off , this is the role for you!

The Utilization Management Assistant answers first level calls in Utilization Review for HealthCheck360 participants. They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You will be responsible for reviewing medical records, coordinating with healthcare providers, and ensuring that patients receive appropriate, cost-effective care in accordance with clinical guidelines and insurance requirements.

Preferred Skills

• Communication - Strong interpersonal skills to be able to connect with patients, doctors, internal team members, and providers
• Customer Service - Friendly demeanor and understanding to be able to relay sensitive information to members
• Detail Oriented - Accuracy and attention to detail when reviewing pre-certifications and plans

Qualifications :

Full-Time Benefits - Most benefits start day 1

About HealthCheck360

HealthCheck 360 was created with the employer's needs and the participant's experience in mind. We focus on reducing medical costs, while increasing employee engagement and productivity. This is accomplished by providing onsite biometric screenings, engaging participants through technology and programming, educating the participant with risk-specific targeted communications, and supporting positive behavior change through our Health Coaching and Condition Management programs.