Remote Utilization Management Associate I – Precert/PA

Elevance Health (Anthem); Miami (FL); Remote; USD 22,000 - 30,000; Full time

Job summary

Elevance Health is seeking a Utilization Management Representative I to coordinate precertification and prior authorization reviews. The role supports a hybrid/virtual work model, with required in-person training and location options in Florida (Lake Mary, Tampa or Miami).

The schedule includes 4 days Mon-Fri 8:30 am–5 pm EST and one weekend day, with potential overtime as needed. The position emphasizes decision support for eligibility, authorization, and case routing, along with multi-tasking

Qualifications

• HS diploma or GED required.
• 1 year of customer service or call-center experience preferred.
• Equivalent education/experience may be considered.

Responsibilities

• Handle incoming calls and post-service claims work.
• Determine contract and benefit eligibility; authorize inpatient/outpatient/precertification and post-service requests.
• Enter referral requests accurately into the UM system.
• Respond to inquiries from clients, providers, and internal teams.
• Coordinate with Nurse reviewers for cases needing clinical review.
• Maintain customer relations and multi-task across channels in a fast-paced environment.

Skills

Customer service

Call-center experience

multitasking

Communication skills

Empathy

Education

HS diploma or GED

Job description

Elevance Health is seeking a Utilization Management Representative I to coordinate precertification and prior authorization reviews. The role supports a hybrid/virtual work model, with required in-person training and location options in Florida (Lake Mary, Tampa or Miami).

The schedule includes 4 days Mon-Fri 8:30 am–5 pm EST and one weekend day, with potential overtime as needed. The position emphasizes decision support for eligibility, authorization, and case routing, along with multi-tasking