Utilization Management Associate - Authorization & UM Support

Capital District Physicians Health Plan Inc; City of Albany (NY); Remoto; USD 28.000 - 37.000; Tempo pieno

Descrizione del lavoro

Capital District Physicians Health Plan Inc is seeking an UM Administrative Support professional to assist in inbound/outbound calls, authorizations via phone and Care Advance Provider Tool, and fax for inpatient and outpatient procedures. You will support internal and external customers and ensure timely, accurate processing.

The role requires strong communication, organization, and teamwork, with the potential for remote work on a case-by-case basis. Prior UM or healthcare experience is a plus.

Competenze

• High School Diploma or GED required.
• Experience with desktop computers in a professional setting.
• Strong written and verbal communication skills.
• Call center experience preferred.
• Analytical and problem-solving abilities.
• Ability to work in a team and manage multiple priorities.
• Self-motivated with the ability to work independently.

Mansioni

• Handle inbound and outbound calls to members and providers delivering customer-centered service.
• Respond professionally to inquiries and support UM services triage.
• Serve as primary contact for provider authorization requests.
• Communicate regulatory requirements (DOH, NCQA) to providers and members.
• Provide timely research responses and process fax requests.
• Maintain member privacy in line with policies and procedures.
• Attend work consistently and complete additional tasks as assigned.

Conoscenze

Customer service

Communication

Problem solving

Teamwork

Organization

Independence

Formazione

High School Diploma or GED

Strumenti

Microsoft Office

Descrizione del lavoro

Capital District Physicians Health Plan Inc is seeking an UM Administrative Support professional to assist in inbound/outbound calls, authorizations via phone and Care Advance Provider Tool, and fax for inpatient and outpatient procedures. You will support internal and external customers and ensure timely, accurate processing.

The role requires strong communication, organization, and teamwork, with the potential for remote work on a case-by-case basis. Prior UM or healthcare experience is a plus.