Utilization Management Support Specialist I — Remote-Optional

Capital District Physicians Health Plan Inc; Town of De Witt (NY); Hybrid; USD 28,000 - 37,000; Full time

Benefits offered by this job

Remote work possibility

Job summary

Capital District Physicians Health Plan Inc is seeking an entry-to-mid level Utilization Management support role focused on administrative duties and customer service. The position handles inbound/outbound calls, creates authorizations, and supports regulatory timelines for DOH/NCQA requirements.

The role requires strong communication, organization, and the ability to work with various providers and members in a team environment. Some remote work may be possible on a case-by-case basis.

Qualifications

• Demonstrated written and verbal communication skills.
• Strong analytical and problem-solving skills.
• Experience with using a desktop computer in a professional environment, preferably with Microsoft Office products.
• Call center experience preferred, not required.

Responsibilities

• Handle inbound and outbound calls with members and providers.
• Process authorizations for inpatient/outpatient services and durable medical equipment.
• Triage UM services and respond to inquiries within regulatory timeframes.
• Collaborate with departments to ensure end-to-end authorization processes.

Skills

MS Office

Call center

Customer service

Communication

Education

High School Diploma or GED

Job description

Capital District Physicians Health Plan Inc is seeking an entry-to-mid level Utilization Management support role focused on administrative duties and customer service. The position handles inbound/outbound calls, creates authorizations, and supports regulatory timelines for DOH/NCQA requirements.

The role requires strong communication, organization, and the ability to work with various providers and members in a team environment. Some remote work may be possible on a case-by-case basis.