Utilization Management Assistant

About the role

Texas Children’s Health Plan is seeking a Utilization Management Assistant to support the intake department. The ideal candidate will have experience in healthcare or insurance environments, preferably in managed care, claims, and member service.

Responsibilities

• Serves as support to the Medical Management Intake Department
• Performs eligibility confirmation and provider/member education
• Collaborates internally with other health plan staff, including the Claims Department and Network Development
• Provides customer service and education for all incoming calls regarding provider and/or product information
• Utilizes resources available from TCHP or State Agencies
• References dates prior to authorizations

Qualifications

• H.S. Diploma or GED required
• 2 years managed care experience, preferably in medical management department, claims, and member service preferred
• Experience in Healthcare or Insurance environment preferred