Remote Utilization Management Associate I

Elevance Health, Inc.; Grand Prairie (TX); Remote; USD 23,000 - 38,000; Full time

Job summary

Elevance Health is seeking an Utilization Management Representative I (US) to coordinate precertification and prior authorization reviews, handle inquiries, determine eligibility, and authorize initial treatment sessions. The role emphasizes accuracy, empathy, and strong communication with clients, providers, and internal teams.

The position offers flexible virtual work with occasional in-person training, and opportunities to work from an office within a commuting distance where applicable.

Qualifications

• Requires HS diploma or GED and at least 1 year of customer service or call‑center experience.
• Healthcare/insurance familiarity is preferred.

Responsibilities

• Coordinate precertification and prior authorization reviews.
• Manage inbound calls and correspondence from clients and providers.
• Determine contract and benefit eligibility.
• Authorize initial set of treatment sessions and check facility-based benefits.
• Escalate to Nurse reviewer for clinical cases as needed.
• Maintain effective communication with internal departments and external stakeholders.

Skills

Customer service

Medical terminology

Communication

Insurance knowledge

Education

High school diploma or GED

Job description

Elevance Health is seeking an Utilization Management Representative I (US) to coordinate precertification and prior authorization reviews, handle inquiries, determine eligibility, and authorize initial treatment sessions. The role emphasizes accuracy, empathy, and strong communication with clients, providers, and internal teams.

The position offers flexible virtual work with occasional in-person training, and opportunities to work from an office within a commuting distance where applicable.