Utilization Management CNA

HealthCheck360; Dubuque (IA); Hybrid; USD 25,000 - 39,000; Full time

Benefits offered by this job

401(k) with company match

PTO/Paid Holidays

Disability (ST & LT)

Job summary

HealthCheck360 is seeking a dedicated Utilization Management Assistant to join our healthcare team in Dubuque, IA. The role involves handling first-level calls, reviewing certifications, and coordinating with providers to ensure appropriate, cost-effective care according to clinical guidelines.

You will work in a professional office setting with daytime hours and occasional remote options, contributing behind the scenes to improve patient outcomes and healthcare efficiency.

Qualifications

• Strong interpersonal communication to connect with patients, doctors, and team members.
• Friendly, empathetic approach for sensitive information.
• Accurate, detail-focused review of pre-certifications and plans.

Responsibilities

• Answer first-level calls in Utilization Review.
• Review patient medical records and coordinate with providers.
• Triage calls to determine need for Utilization Review Nurse.
• Help ensure cost-effective, guideline-compliant patient care.

Skills

Communication

Customer Service

Detail Oriented

Education

CNA

LPN

Medical Assistant

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. Y ou 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
• 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

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.