Remote Healthcare Utilization Management Coordinator (LPN/LVN)

Job Overview

  • Clinical License LPN
  • State(s) Nationwide

Role description

Healthcare Utilization Management Coordinator

Associate I – BPM 

 

 

Who we are:

Founded in 2016, we’ve become a trusted and valued partner for health plans and providers. We offer a modern integrated ecosystem of healthcare operations, processes, and products, with inherent scalability, efficiency, and predictable outcomes. Our BPaaS delivery solutions work behind the scenes to manage our customers’ complex admin operations, giving them elbow room to focus on their members’ needs and well-being.

Bending cost curves, guaranteeing outcomes, finding paths through roadblocks – that’s our way of life. Our customers count on us to safely navigate them through deadlocks. We have a strong global presence and a dedicated workforce of 4000+ people spread across the world.

Our brand is built on strong foundations of simplicity, honesty, and leadership, and we stay inspired in our goal to unburden healthcare and ensure it reaches all, equitably and effectively.

 

You Are:

UST HealthProof is searching for a Healthcare Utilization Management Intake Analyst who will support coordination of medical services including utilization management intake, requesting medical records, and provider requests to promote effective utilization of healthcare services. Promotes and supports utilization management team as required.

 

The Opportunity:

·       Provide support services to team members by answering incoming telephone calls, taking messages, researching information and building authorizations in the UM system.

·       Requesting medical records for pending authorizations or continued stay authorizations.

·       Generate UM letters for members and providers when authorizations are not required. • Refers to needed services in accordance to benefit plan.

·       Maintain accurate and complete documentation of required information that meets quality standards.

·       Protect the confidentiality of the member information and adheres to the company policies regarding confidentiality.

 

 

This position description identifies the responsibilities and tasks typically associated with the performance of the position.  Other relevant essential functions may be required.

 

What you need:

·       High school diploma or G.E.D. required. Associate or bachelor’s degree in health care related field is preferred. Current unrestricted LPN license or certified Medical Assistant designation preferred.

·       Minimum of one year experience in a health care related field. Preferred setting is hospital, medical doctor’s office, or health insurance company.

·       Experience with medical terminology and concepts used in the healthcare delivery system, provider office, or the insurance industry is required.

·       Computer literacy to include Microsoft Office products

·       Advanced technical skills for use of hardware and software with a high degree of accuracy.

·       Excellent oral and written communication skills for representation of clear and concise results.

·       Ability to manage significant workload, and to work efficiently under pressure, meeting established deadlines with minimal supervision.

·       Strong time management skills.

·       Must possess high degree of accuracy, efficiency, and dependability.

·       Strong customer service skills to assist members and/or providers with understanding healthcare information and to coordinate issue resolution.

·       Effective written and verbal communication and feedback.

·       Effective organizational skills with ability to be flexible and prioritize tasks.

·       Knowledge of educational assessments and learning strategies.

·       Must be knowledgeable of and able to use standard, basic grammar, punctuation, and spelling.

 

Compensation can differ depending on factors including but not limited to the specific office location, role, skill set, education, and level of experience. As required by applicable law, UST provides a reasonable range of compensation for roles that may be hired in various U.S. markets as set forth below.

Role Location: Remote

Compensation Range:   $31,200-$35,360

 

Our full-time, regular associates are eligible for 401K matching, and vacation accrual and are covered from day 1 for paid sick time, healthcare, dental, vision, life, and disability insurance benefits.

 

 

What We Believe

At UST HealthProof, we envision a bold future for American healthcare. Our values are the bedrock beliefs our organization holds dear. They not only define what our brand stands for but also serves as a compass guiding every action and decision.

Guiding Principles

These principles illuminate the path of ‘how’ we operate. They detail actions and behaviors we much embody to honor our values and achieve our goals.

Integrity

Integrity is our currency to build relationships. We believe in being open and honest. It is only natural when we have nothing to hide. It demonstrates that we are here to do the right thing, no matter who is watching.

People-Centricity

Everything that we do reflects our deep bonds with peers and customers. These aren’t mere transactions, but transformational ties. They shape our culture and decisions, affirming that our true value lies in the lives we touch and impact.

Simplicity

Simplifying complexity underlines everything we do – this approach is what makes us unique. We come with an open mind and straightforward approach, cutting our way to the core with measurable and actionable insights.

Leadership

Taking ownership is about taking initiative, being in-charge and driving things to completion. It’s a brave choice to ‘own’ all aspects of our work, ensuring we take full responsibility for everything we handle.

Mission

A future possible only when health plans are free from administrative burdens so they can truly focus on what matters more – their members’ well-being.

 

Skills

Healthcare,Medical Management,Workflow

Benefits

Compensation range: $ 31,200.00 to 35,360.00 per year

 

 

 

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