Demo

Utilization Management Technician

AmeriHealth Caritas
Remote, OR Remote Full Time
POSTED ON 3/1/2025
AVAILABLE BEFORE 5/25/2025

Responsibilities

The Utilization Management Tech functions under the direction of the Supervisor to coordinate, generate, and track both incoming and outgoing correspondence, faxes, and authorizations related to prospective, concurrent, and post-service review functions. Interacts with facilities, vendors, providers, and other staff to facilitate receipt of information and / or records for prompt review and response. Compensation plans for physicians, licensed nurse reviewers, staff, and consultants who conduct medical management do not contain incentives, directly or indirectly, that encourage barriers to care and service in making determinations.

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 can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

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

Our Comprehensive Benefits

Package Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

Generous paid time off and paid volunteer time off.

Employer-matched 401(k) and additional non-elective contributions, starting on day one.

Medical, dental, and vision plans — with coverage starting on day one.

Employee assistance programs, fitness reimbursements, nutrition counseling, and more.

Employer-paid life insurance, with opportunities to purchase additional coverage.

Employer-paid short-term disability coverage and long-term disability coverage.

Tuition assistance, including reduced tuition at certain schools.

Financial assistance with adoption, including paid time off.

Flexible spending and health savings accounts to pay for qualified expenses.

Discount programs on entertainment, travel, and more.

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