Senior Utilization Management Assistant - Utilization Management FT DAY - REMOTE

Providence Health Plan Group; Irvine, Northern (CA, KY); Hybrid; USD 71,635,000 - 102,631,000; Full time

Job summary

Providence Jobs in California seeks a Senior Utilization Management Assistant for a fully remote, full-time role with day shifts. You will assist the Care Management team, coordinating patient care and handling administrative tasks related to utilization review and admissions.

Strong hospital/healthcare experience and knowledge of insurance/billing are essential. Join a mission-driven provider network with comprehensive benefits and a focus on patient-centered, whole-person care in a

Qualifications

• 5 years Hospital, clinical setting or healthcare related field.
• 3 years Demonstrated outstanding customer service experience.
• 3 years Clerical and computer experience.
• 3 years Knowledge of insurance billing and managed care.
• Coursework/Training Some college level course work Or equivalent educ/experience
• High School Diploma or GED equivalent or some college level course work preferred particularly Medical Terminology or Medical Assistance coursework.
• Coursework/Training Medical Terminology or Medical Assistant Or equivalent educ/experience
• Coursework/Training CHAA Or equivalent educ/experience
• Within 6 months (180 days) of hire: CHAA (If in California)
• 3 years EPIC Case Management and ADT Patient Access.

Responsibilities

• Under supervision of Regional Director of Care Management, provides support to the Care Management team.
• Coordinates care as part of the healthcare team.
• Performs complex tasks related to assessment and management of patients.
• Supports wage range communications and broader team activities.

Skills

Hospital/Healthcare experience

Customer service

Clerical/Computer skills

Insurance billing & managed care

Education

Some college/educ/experience

HS diploma or GED

Medical terminology/MA coursework

CHAA or equivalent education/experience

CHAA within CA hire window

EPIC Case Management exposure

Tools

EPIC Case Management

ADT Patient Access

Job description

Description

Senior Utilization Management Assistant- REMOTE position. This position is Full time and will work 8- hour, Day shifts.

Under the supervision of Regional Director of Care Management, the Utilization Management Coordinator is responsible for providing support to the Care Management team who coordinates care. This position works closely as a healthcare team member and performs complex tasks related to the overall team functions and activities identified during the initial and ongoing assessment and management of patients.

Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence California Regional Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Required Qualifications:

• 5 years Hospital, clinical setting or healthcare related field.
• 3 years Demonstrated outstanding customer service experience.
• 3 years Clerical and computer experience.
• 3 years Knowledge of insurance billing and managed care.

Preferred Qualifications:

• Coursework/Training Some college level course work Or equivalent educ/experience
• High School Diploma or GED equivalent or some college level course work preferred particularly Medical Terminology or Medical Assistance coursework.
• Coursework/Training Medical Terminology or Medical Assistant Or equivalent educ/experience
• Coursework/Training CHAA Or equivalent educ/experience
• Within 6 months (180 days) of hire: CHAA (If in California)
• 3 years EPIC Case Management and ADT Patient Access.

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.

Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

About the Team

The Sisters of Providence and Sisters of St. Joseph of Orange have deep roots in California, bringing health care and education to communities from the redwood forests to the beach shores of Orange county - and everywhere in between. In Southern California, Providence provides care throughout Los Angeles County, Orange County, High Desert and beyond.

Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care, and even our own Providence High School.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Company: Providence Jobs

Job Category: Health Information Management

Job Function: Revenue Cycle

Job Schedule: Full time

Job Shift: Multiple shifts available

Career Track: Admin Support

Department: 7000 UTILIZATION MGMT OCHD

Address: CA Irvine 15480 Laguna Canyon Rd

Work Location: Providence System Offices Discovery Park-Irvine

Workplace Type: Remote

Pay Range: $25.00 - $35.77

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.