Utilization Management Assistant
Utilization Management Assistant
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Job Description
Job Details
Do you want to work at one of the Top 100 Hospitals in the nation We are guided by our values ofLoveandExcellenceand are passionate about delivering health not just health care. Come join us at ChristianaCare!
Our Utilization Management departmentlocated in Newark Delaware DE is looking for a full time Utilization Management Assistant to use internal and external resources to resolve social emotional and environmental needs by verifying benefits obtaining insurance authorizations placing orders to vendors and accurately entering data into clinical information systems.
The ideal candidate will be well organized detail oriented and have the ability to multitask. Candidate to complete tasks and duties within a prescribed timeline. Strong computer skills as well as good verbal and written communication skills.
Benefits of working at ChristianaCare
- Generous PTO Competitive Pay & Robust Benefits Package.
- 403B company match and Tuition Reimbursement
- 12 weeks Paid Parental Leave
Responsibilities of the Utilization Management Assistant will include;
- Perform duties adhering to the ChristianaCare Core Values and Behaviors guided by Excellence and Love.
- Provides administrative support to the team; assists with copying faxing form completion addressing emails and Medicare letters by department standards.
- Assists with completion of Utilization Management duties including providing clinical information to insurance companies to obtain authorizations and updating patient records timely.
- Assists in contacting patient and families to discuss level of care status changes and appeal options with insurance.
- Assist in scheduling phone calls and meetings for members of the UM team with payer representatives.
- Establish a knowledge base for medical necessity requirements for all major insurance companies.
- Assists with routine calls emails faxes from insurance companies.
- Assists with general support services and office coverage as staffing needs dictate.
- Establishes collaborative relationships with Utilization Managers Care Managers and other health care staff to effectively and efficiently complete necessary services.
- Enters accurate data authorization/referral entries into computer system as directed by team in an accurate and timely manner.
- Calls insurance companies for authorization benefit verification and coverage information as necessary.
- Executes proper use of the telephone and voice mail systems. Incorporates services standards for telephone contact into daily activities
- Provides superior customer service to providers and members.
- Communicates effectively with the Utilization Management and Care Management department as well as other departments in the Christiana Care Health System.
- Performs specific projects as directed by Supervisor and/or Director.
- Acquires new skills needed for performing job functions as the healthcare/delivery system changes.
- Participates as an active member of the team offering suggestions and recommendations for more effective and efficient operations.
- Maintains confidentiality of patient information.
- Participates in seminars/workshops and in-service education regarding new resources.
- Adheres to Christiana Care policies and procedures including but not limited to annual Fire and Safety
- Infection Control procedures and demonstrates core values.
- Perform assigned work safely adhering to established departmental safety rules and practices. Addresses and/or reports to Managers/Director in a timely manner any unsafe activities conditions hazards or safety violations that may cause injury to oneself other caregivers patients and visitors.
- Scheduling and calendar management managing appointments and meetings for leaders
- Maintaining organized filing systems both electronic and physical and retrieving information as needed
- Meeting coordination preparing meeting agendas taking minutes and ensuring logistics are handled effectively
- Office management ordering office supplies
- Supports the onboarding of new hires by arranging necessary accesses vocera IT needs desk
- Monitor IT equipment needs; order necessary equipment; enter IT tickets as needed
- Performs other related duties as required
Knowledge Skill and Ability Requirements:
- Knowledge of ChristianaCare and departmental policies procedures and standards
- Knowledge of Joint Commission requirements and standards
- Proficient with Microsoft Word Excel and PowerPoint
- Ability to function as a member of an interdisciplinary team.
- Ability to learn and understand basic medical terminology.
- Understand HIPPA/Privacy regulations with patient medical records
- Knowledge of PC including EMR applications
- Typing proficiency
- Strong organization and superior communication skills are required.
- Knowledge of the insurance authorization process is preferred.
- Ability to use telephone communication systems
- Ability to orally communicate effectively.
- Ability to identify issues troubleshoot problems and find effective solutions
- Ability to adapt to changing priorities and manage multiple tasks simultaneously
Office Hours:Day Shift
Qualifications:
- High School diploma or equivalent required.
- Four years progressively responsible administrative support to an administrator or manager.
- Five years of experience in a support role in Case Management/Utilization Management experience preferred
Special Requirement:
Stability to work under emotional time and volume pressure
Physical Demands:
- Intermittent sitting standing and lifting. Capable of getting from and to nursing units and other areas of the facilities as required.
Working Conditions:
- Occasional contacts with patients who have a communicable disease or who may behave violently. Hospital office space.
About ChristianaCare
ChristianaCare was recognized as one of Americas 100 Best Hospitals by Healthgrades selected as one of the Most Wired Hospitals in the US by the American Hospital Association and ranked by US News & World Report as the #3 Best Hospital in the Philadelphia region out of more than 90 hospitals. To learn more click on this link Care Health System is an equal opportunity employer firmly committed to prohibiting discrimination whose staff is reflective of its community and considers qualified applicants for open positions without regard to race color sex religion national origin sexual orientation genetic information gender identity or expression age veteran status disability pregnancy citizenship status or any other characteristic protected under applicable federal state or local law.
We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process to perform essential job functions and to receive other benefits and privileges of employment. Please contact us to request accommodation.
Post End Date
May 27 2025EEO Posting Statement
Christiana Care Health System is an equal opportunity employer firmly committed to prohibiting discrimination whose staff is reflective of its community and considers qualified applicants for open positions without regard to race color sex religion national origin sexual orientation genetic information gender identity or expression age veteran status disability pregnancy citizenship status or any other characteristic protected under applicable federal state or local law.
Employment Type
Full-Time
