What are the responsibilities and job description for the Utilization Management Assistant position at APR Consulting?
APR Consulting, Inc. has been engaged to identify a Utilization Management Assistant
Location: Everett, WA 98201
Position: Utilization Management Assistant
Pay Rate: $29.74/hr
Duration: 13 weeks
Expected Shift: Day 5x8-Hour (07:00 - 16:30)
Hybrid position: Remote and On-site - will be on-site 2 days/week at Everett Pacific Campus
Core Activities:
This particular client is requiring that all new hires show proof of vaccination. However, accommodations may be made for those with disabilities or religious reasons who cannot obtain a vaccine.
Since 1980 APR Consulting, Inc. has provided professional recruiting and contingent workforce solutions to a diverse mix of clients, industries, and skill sets nationwide.
We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.
Don't miss out on this amazing opportunity! If you feel your experience is a match for this position please apply today and join our team. We look forward to working with you!
Location: Everett, WA 98201
Position: Utilization Management Assistant
Pay Rate: $29.74/hr
Duration: 13 weeks
Expected Shift: Day 5x8-Hour (07:00 - 16:30)
Hybrid position: Remote and On-site - will be on-site 2 days/week at Everett Pacific Campus
Core Activities:
- Updating payer authorizations
- Working denials
- Monitoring faxes and inputting into Epic and Genesis
- Working in provider portals (Availity)
- Sending clinicals to payers
- Must be experienced with entire Microsoft Suite (Word, Excel, Teams, PowerPoint, Access)
- Must be independent, self-motivated, and trustworthy in working remotely - must be comfortable working in Teams to communicate with co-workers remotely
- Epic experience required
- No background check concerns with financial-related violations as this position involves access to patient financial information
- Knowledge of managed health care market place, health delivery systems, contract basics.
- Beginning knowledge of CMS, NCQA, DMHC, ADA and HIPAA regulations.
- Associate's Degree Required
- The primary responsibility of the position is to maintain standard compliance and performance related utilization management data.
- Process of daily, weekly and monthly UM reports. Establishes and maintains efficient filing system in paper and electronic.
- Maintains Health Plan audit tools including the distribution and collection of data and documentation.
- Assists in data collection for all Health Plan audits and in necessary compilation of data for NCQA, DMHC and CMS focused audits and unplanned audits of the delegated Medical Group as downstream providers.
- Performs other duties as assigned by immediate Supervisor UM Compliance Manager and in support of compliance timelines.
- Under the supervision of Administrative Director of Health Services.
- The position requires strong analytical and utilization modeling skills employing data from the Referral, Beddays and claims data bases published by Decision Support.
- Requires strong interpersonal, professional communication skills. Answers and screens phones.
This particular client is requiring that all new hires show proof of vaccination. However, accommodations may be made for those with disabilities or religious reasons who cannot obtain a vaccine.
Since 1980 APR Consulting, Inc. has provided professional recruiting and contingent workforce solutions to a diverse mix of clients, industries, and skill sets nationwide.
We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.
Don't miss out on this amazing opportunity! If you feel your experience is a match for this position please apply today and join our team. We look forward to working with you!
Salary : $30