Utilization Management Technician,

AmeriHealth Caritas; Indiana; On-site; USD 35,000 - 50,000; Full time

Job summary

A leading health care organization is seeking a Utilization Management Tech to coordinate and manage correspondence related to service reviews. This role involves collaboration with various stakeholders to ensure efficient information flow. The ideal candidate will have customer service experience and familiarity with healthcare settings. Join us to make a difference in health care delivery and enjoy comprehensive benefits from day one.

Benefits

Health Insurance from Day 1

401(k)

Tuition Reimbursement

Paid Time Off

Qualifications

• Minimum of 1 year of general office and/or customer service experience preferred.
• Work experience in utilization management/review in a healthcare/MCO setting preferred.

Responsibilities

• Coordinate, generate, and track correspondence related to service reviews.
• Interact with facilities, vendors, providers, and staff for information.

Skills

Customer Service

Communication

Organizational Skills

Education

High School/GED

Associate’s Degree

Tools

Microsoft Office Suite

Job description

Your career starts now. We are looking for the next generation of health care leaders.

At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions through our broad range of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you want to make a difference, we would like to hear from you.

Headquartered in Newtown Square, Pennsylvania, AmeriHealth Caritas is a mission-driven organization with over 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. Our services include integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Responsibilities:

The Utilization Management Tech works under the supervision of the Manager to coordinate, generate, and track incoming and outgoing correspondence, faxes, and authorizations related to prospective, concurrent, and post-service reviews. The role involves interacting with facilities, vendors, providers, and staff to facilitate the receipt of information and records for prompt review and response. Compensation plans for physicians, licensed nurse reviewers, staff, and consultants involved in medical management do not include incentives that encourage barriers to care and service in decision-making.

Education/Experience:

• High School/GED required.
• Associate’s Degree or equivalent education & experience preferred.
• Minimum of 1 year of general office and/or customer service experience preferred.
• Work experience in utilization management/review in a healthcare/MCO setting preferred.
• Knowledge of medical terminology preferred.
• Minimum of 1 year experience in Managed Care, Insurance, or Call Center preferred.
• Proficiency with Microsoft Office Suite (Word, Excel, PowerPoint) required.

Diversity, Equity, and Inclusion

At AmeriHealth Caritas, everyone is valued, supported, and encouraged to be themselves. Our commitment to equity ensures all associates have a fair opportunity to reach their full potential. We act with integrity and respect daily, speak out against injustice, and work to break down barriers for a more inclusive and equitable workplace. Embracing diverse perspectives makes us more vibrant, innovative, and better equipped to serve our communities.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits

We offer competitive pay, paid time off including holidays and volunteer events, health insurance coverage from Day 1, 401(k), tuition reimbursement, and more.