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Jobs or company...

Utilization Management Support Assistant

  • Full Time, onsite
  • Bernard Nickels & Associates
  • United States, United States of America
Salary undisclosed

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Type: Contract

Duration: 6 Months (w/ potential for extension)

Location: Remote

Work Schedule: Monday-Friday, 8:30/9am–5/5:30pm EST

Pay Range: $17 to $20 per hour

Job Summary: The Utilization Management (UM) Support Assistant will play a critical role in supporting our leading vision care client's upcoming "Go Live" for Kansas, Florida, and Michigan, scheduled for January 1st. The primary focus of this role is administrative and data entry work to process UM prior authorization requests. The position involves working with various systems, including Facets, Filebound, and Jira, and requires making outbound notification calls to providers and members.

Responsibilities:

  • Provide administrative support for UM prior authorization requests in preparation for the Go Live.
  • Perform data entry tasks and system updates using Facets, Filebound, and Jira.
  • Make outbound notification calls to healthcare providers and members regarding prior authorization requests.
  • Ensure timely and accurate processing of requests to meet the January 1st Go Live deadline for Kansas, Florida, and Michigan.
  • Collaborate with internal teams to ensure smooth implementation and support.

Qualifications:

  • High School Diploma/GED required. A college degree is preferred.
  • Proven data entry experience.
  • Familiarity with Microsoft Excel and Office Suite.

Preferred Skills:

  • Strong critical thinking and problem-solving abilities.
  • Excellent attention to detail and accuracy in handling data.
  • Ability to multitask and prioritize tasks effectively in a fast-paced environment.
  • Previous experience with HealthFirst and Anthem prior authorization processes is a plus.
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