Utilization Management Support Specialist I - Remote Tues-Sat

Santa Barbara Cottage Hospital; United States; Remote; USD 37,000 - 57,000; Full time

Job summary

A leading healthcare organization is seeking a Utilization Management Support Specialist I to provide essential non-clinical support within utilization management workflows. This role involves assisting with peer-to-peer reviews, scheduling, and maintaining stakeholder relationships. Ideal candidates will have healthcare experience and strong communication skills, with a preference for those holding an Associate degree.

Qualifications

• Experience in healthcare is required.
• Preferred education is an Associate degree.

Responsibilities

• Assist in physician advisor process for peer-to-peer reviews.
• Support scheduling and communication of results.
• Provide non-clinical support to utilization management workflows.

Skills

Health plan benefit structures

Psychiatric/medical terminology

Verbal communication

Written communication

Interpersonal effectiveness

Personal accountability

Adaptability

Relationship building

Education

Associate degree

Job description

ATTENTION MILITARY AFFILIATED JOB SEEKERS - Our organization partners with companies to source qualified talent for open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers. If you meet the required skills, education, and experience, please click the submit button and follow the next steps. Unless otherwise stated, this role is On-Site at the location specified in the job post.

Required experience/skills:

• Understands health plan benefit structures.
• Familiarity with psychiatric/medical terminology.
• Strong verbal and written communication skills.
• Initiative and interpersonal effectiveness.
• Personal accountability and adaptability.
• Ability to build strong interpersonal work relationships.

Schedule: Tuesday - Saturday, 9:30am - 6:00pm Central Time.

Responsibilities include assisting in the physician advisor process for peer-to-peer reviews, supporting scheduling, communicating results, and completing correspondence. Provides non-clinical support to utilization management workflows, conducts outreach to providers and members, and ensures cases meet guidelines. Researches cases, documents task completion, and maintains stakeholder relationships. Identifies and escalates risks, achieves performance standards, and prepares various letters. Troubleshoots issues, validates data, and participates in operational activities. Also mentors new team members and manages correspondence distribution.

Additional Qualifications/Responsibilities: Same as above skills and knowledge requirements.

General Job Information:

• Title: Utilization Management Support Specialist I
• Grade: 19
• Work Experience - Required: Healthcare
• Education - Preferred: Associate degree
• Salary Range: $37,725 - $56,595