Utilization Management Assistant
About the role
The Utilization Management Assistant answers first level calls in Utilization Review for our Health & Wellness participants. They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You will be responsible for reviewing medical records, coordinating with healthcare providers, and ensuring that patients receive appropriate, cost-effective care in accordance with clinical guidelines and insurance requirements.
Responsibilities
- Evaluate certification requests by reviewing the group specific requirements
- Triage calls to determine if a Utilization Review Nurse is needed
- Review medical records
- Congnorate with healthcare providers
- Ensure patients receive appropriate, cost-effective care
Qualifications
- CNA, LPN, or Medical Assistant preferred
- Background in patient health support or care
- 1+ years of experience within this field
Benefits
- Full-Time Benefits
- Medical, Dental, Vision Insurance
- Flex Spending or HSA
- 401(k) with company match
- Profit-Sharing/Defined Contribution (1-year waiting period)
- PTO/Paid Holidays
- Company-paid ST and LT Disability
- Maternity Leave/Parental Leave
- Subsidized Parking
- Company-paid Term Life/Accidental Death Insurance
About Cottingham & Butler
At Cottingham & Butler, we sell a promise to help our clients through life’s toughest moments. To deliver on that promise, we aim to hire, train, and grow the best professionals in the industry. We look for people with an insatiable desire to succeed, are committed to growing, and thrive on challenges. Our culture is guided by the theme of “better every day” constantly pushing ourselves to be better than yesterday – that’s who we are and what we believe in.