Utilization Management Assoc / Clinical Resource Management
Hartford HealthCare · Wethersfield, CT · 1 wk ago
OTHRFull-time
Location: 1290 Silas Deane Hwy, Wethersfield, CT 06109
First shift hours, Monday through Friday, no holidays or weekends.
About the Role
The Clinical Resource Management Associate is an integral part of the Care Management team. The role focuses on providing support and coordination of utilization management services for the utilization management department within Integrated Care Partners (ICP), a physician-led, clinically integrated healthcare network.
Responsibilities
- Monitors and manages assigned utilization management reports, including the Payer End of Day report, Utilization Management list, Discharge Log, and the Discharge Disposition report for payers.
- Monitors and manages assigned EPIC work queues.
- Updates EPIC with authorization and denial information.
- Provides the Clinical Resource Management Nurse with support for denials, appeals, and physician advisor communication.
- Retrieves, manages, and/or triages department phone calls, voicemails, fax requests, and Tiger Texts.
- Communicates with payers, case management, medical records, and other departments.
- Scans and uploads documentation into the electronic health records.
- Performs routine and administrative tasks within the scope of non-licensed personnel.
- Manages Certification Email process.
- Other duties as assigned by supervisor.
Requirements
- High School Diploma (Medical Administrative Assistant certification preferred).
- Two or more years of professional work experience in healthcare, managed care, or insurance.
Skills
- Strong interpersonal and communication skills.
- Effective time management skills; able to work in a fast-paced environment with changing priorities.
- Effective organizational skills.
- High-level understanding of confidentiality and HIPAA requirements.
Benefits
Hartford HealthCare offers a competitive benefits program designed to ensure work/life balance, along with opportunities for career development and growth across various locations in the state.