Utilization Management Specialist

Utah; Salt Lake City (UT); On-site; USD 40,000 - 60,000; Full time

Job summary

University of Utah Health is seeking a qualified individual for a position focused on utilization review coordination. Responsibilities include managing prior authorization requests and assisting both providers and members with verification and communication processes. Candidates must have at least two years of experience in healthcare and a solid understanding of medical terminology.

This role offers a collaborative work culture and values individuals from diverse backgrounds, promoting a commitment to improving healthcare accessibility.

Qualifications

• Understanding of medical terminology.
• Previous experience in a utilization review setting.
• Ability to handle highly sensitive and confidential issues in a professional manner.

Responsibilities

• Assisting with coordination of utilization review, concurrent review and medical necessity review.
• Receives requests for prior authorization and enters them in the Utilization Management Platform.
• Checks eligibility, network status, and procedure coverage.

Skills

Effective communication

Human relations

Computer literacy

Education

Two years of health care experience or education equivalency

Bachelor's degree in a health-related discipline, business, or the equivalency

Tools

CPT, ICD-10, HCPCS coding

Job description

University of Utah Health is seeking a qualified individual for a position focused on utilization review coordination. Responsibilities include managing prior authorization requests and assisting both providers and members with verification and communication processes. Candidates must have at least two years of experience in healthcare and a solid understanding of medical terminology.

This role offers a collaborative work culture and values individuals from diverse backgrounds, promoting a commitment to improving healthcare accessibility.