Remote Utilization Management Assistant

HealthCheck360; United States; Hybrid; USD 36,000 - 48,000; Full time

Benefits offered by this job

Medical, Dental, Vision Insurance

Flex Spending/HSA

401(k) with company match

PTO/Paid Holidays

Company-paid Disability

Maternity Leave/Parental Leave

Subsidized Parking

Term Life/AD&D Insurance

Job summary

HealthCheck360 is seeking a dedicated Utilization Management Assistant to join our clinical operations team in Dubuque, IA, with options for remote applicants. The role handles first-level Utilization Review calls, reviews certifications, triages to a nurse when needed, and supports coordinating with providers to ensure appropriate, cost-effective care.

The ideal candidate has CNA/LPN/Medical Assistant experience, 1+ year in health support, and strong communication with patients and staff;

Qualifications

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

Responsibilities

• Answer first level calls in Utilization Review for HealthCheck360 participants.
• Evaluate certification requests by reviewing group-specific requirements.
• Triage to determine if a Utilization Review Nurse is needed.
• Review medical records and coordinate with healthcare providers.
• Ensure patients receive appropriate, cost-effective care per clinical guidelines and insurance requirements.

Skills

Communication

Customer Service

Detail Oriented

Education

CNA/LPN/Medical Assistant preferred

Background in patient health support or care

Job description

HealthCheck360 is seeking a dedicated Utilization Management Assistant to join our clinical operations team in Dubuque, IA, with options for remote applicants. The role handles first-level Utilization Review calls, reviews certifications, triages to a nurse when needed, and supports coordinating with providers to ensure appropriate, cost-effective care.

The ideal candidate has CNA/LPN/Medical Assistant experience, 1+ year in health support, and strong communication with patients and staff;