Utilization Management Assistant

HealthCheck360; Dubuque (IA); Hybrid; USD 25,000 - 36,000; Full time

Benefits offered by this job

Medical, Dental, Vision Insurance

401(k) with company match

PTO/Paid Holidays

Disability insurance

Job summary

HealthCheck360 is seeking a dedicated Utilization Management Assistant to join our healthcare team in Dubuque, IA. This onsite role welcomes remote applicants and involves handling first-level Utilization Review calls, reviewing medical records, and coordinating with providers to ensure appropriate, cost-effective care per guidelines.

Preferred candidates include CNAs, LPNs, or Medical Assistants with 1+ years in patient care and strong communication, customer service, and attention to detail.

Qualifications

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

Responsibilities

• Answer first-level calls in Utilization Review for HealthCheck360 participants.
• Triages calls to determine if a Utilization Review Nurse is needed.
• Review medical records and coordinate with healthcare providers.

Skills

Communication

Customer Service

Detail Oriented

Education

CNA/LPN/MA preferred

Job description

Location

Onsite in Dubuque, IA. Also accepting remote applicants.

Are you passionate about patient care and thrive in a fast-paced, professional environment? We are seeking a dedicated Utilization Management Assistant to join our healthcare team. We are looking for individuals with experience in a medical setting, including but not limited to a receptionist, scheduler, insurance verification, LPN, CNA, Medical Assistants, or individuals with a background in customer service who are looking to make a meaningful impact behind the scenes. If you are looking to get into a professional office setting with daytime office hours and weekends/holidays off, this is the role for you!

The Utilization Management Assistant answers first level calls in Utilization Review for HealthCheck360 participants. They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You will be responsible for reviewing medical records, coordinating with healthcare providers, and ensuring that patients receive appropriate, cost-effective care in accordance with clinical guidelines and insurance requirements.

Preferred Skills

• Communication - Strong interpersonal skills to be able to connect with patients, doctors, internal team members, and providers
• Customer Service - Friendly demeanor and understanding to be able to relay sensitive information to members
• Detail Oriented - Accuracy and attention to detail when reviewing pre-certifications and plans

Qualifications

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

Full-Time Benefits - Most benefits start day 1

• Medical, Dental, Vision Insurance
• Flex Spending or HSA
• 401(k) with company match
• Profit-Sharing/Defined Contribution (1-year waiting period)
• PTO/Paid Holidays
• Company-paid ST and LT Disability
• Maternity Leave/Parental Leave
• Subsidized Parking
• Company-paid Term Life/Accidental Death Insurance

About HealthCheck360

HealthCheck 360 was created with the employer's needs and the participant's experience in mind. We focus on reducing medical costs, while increasing employee engagement and productivity. This is accomplished by providing onsite biometric screenings, engaging participants through technology and programming, educating the participant with risk-specific targeted communications, and supporting positive behavior change through our Health Coaching and Condition Management programs.