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Utilization Management Specialist
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$63k-88k (estimate)
Full Time 3 Weeks Ago
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Corewell Health Corporate is Hiring an Utilization Management Specialist Near Southfield, MI

This is a benefit-eligible position.

The starting rate for this position is $16.52 per hour and varies based on experience.

Job Summary

Under general direction, assists in the provision of the highest service level possible to patients/customers to ensure their satisfaction. Participates in activities with third party payors in order to maximize reimbursement.

Essential Functions

  • Understands and accesses insurance websites. Completes required duties as defined for specific payers to obtain authorization numbers for payment.
  • Provides clerical support for Utilization Management; sorting faxes and mail, obtaining authorization numbers, completing follow-up on outstanding cases, and delivery of letters associated with outpatient or inpatient status.
  • Utilizes electronic medical record work queues that support Utilization Management functions.
  • Answers incoming calls or places outbound calls with appropriate communication skills. Triages all calls to the appropriate person for resolution and action or completes appropriate follow-up.
  • Problem solves issues that are received via phone, fax or email.
  • Other duties as assigned.

How Corewell Health cares for you 

  • Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here
  • On-demand pay program powered by Payactiv 
  • Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more! 
  • Optional identity theft protection, home and auto insurance, pet insurance 
  • Traditional and Roth retirement options with service contribution and match savings 
  • Relocation assistance (OPTIONAL) 

Qualifications

  • Required High School Diploma or equivalent
  • Preferred Post high school training and/or academic coursework leading toward associate’s or bachelor’s degree.
  • 2 years of relevant experience healthcare experience. Preferred

About Corewell Health 

As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence. 

Primary Location

SITE - Beaumont Service Center - 26901 Beaumont Blvd

Department Name

Utilization Management - CH East

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

40

Hours of Work

Variable

Days Worked

Monday to Friday

Weekend Frequency

N/A

CURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.

Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.

Job Summary

JOB TYPE

Full Time

SALARY

$63k-88k (estimate)

POST DATE

05/08/2024

EXPIRATION DATE

08/03/2024

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The job skills required for Utilization Management Specialist include Utilization Management, etc. Having related job skills and expertise will give you an advantage when applying to be an Utilization Management Specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Utilization Management Specialist. Select any job title you are interested in and start to search job requirements.

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The following is the career advancement route for Utilization Management Specialist positions, which can be used as a reference in future career path planning. As an Utilization Management Specialist, it can be promoted into senior positions as an Utilization Review Manager - Home Care that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Utilization Management Specialist. You can explore the career advancement for an Utilization Management Specialist below and select your interested title to get hiring information.