[Hiring] Utilization Management Assistant @HealthCheck360

Role Description

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 involves:

• Answering first level calls in Utilization Review for HealthCheck360 participants.
• Evaluating certification requests by reviewing group specific requirements.
• Triage calls to determine if a Utilization Review Nurse is needed.
• Reviewing medical records and coordinating with healthcare providers.
• Ensuring that patients receive appropriate, cost-effective care in accordance with clinical guidelines and insurance requirements.

Qualifications

• CNA, LPN, or Medical Assistant preferred.
• Background in patient health support or care.
• 1+ years of experience within this field.

Requirements

• Strong interpersonal skills to connect with patients, doctors, internal team members, and providers.
• Friendly demeanor and understanding to relay sensitive information to members.
• Accuracy and attention to detail when reviewing pre-certifications and plans.

Benefits

• Most benefits start day 1.
• Medical, Dental, Vision Insurance.
• Flex Spending or HSA.
• 401(k) with company match.
• Profit-Sharing/Defined Contribution (1-year waiting period).
• PTO/Paid Holidays.
• Company-paid ST and LT Disability.
• Maternity Leave/Parental Leave.
• Subsidized Parking.
• Company-paid Term Life/Accidental Death Insurance.

Company Description

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 participants with risk-specific targeted communications.
• Supporting positive behavior change through our Health Coaching and Condition Management programs.