Utilization Management CNA

About the role

Onsite in Dubuque, IA. Also accepting remote applicants. Are you passionate about patient care and thrive in a fast-paced, professional environment? We are seeking a dedicated Utilization Management Assistant to join our healthcare team. We are looking for individuals with experience in a medical setting, including but not limited to a receptionist, scheduler, insurance verification, LPN, CNA, Medical Assistants, or individuals with a background in customer service who are looking to make a meaningful impact behind the scenes. If you are looking to get into a professional office setting with daytime office hours and weekends/holidays off, this is the role for you!

Responsibilities

• Answers first level calls in Utilization Review for HealthCheck360 participants.
• Evaluates certification requests by reviewing group specific requirements.
• Triage calls to determine if a Utilization Review Nurse is needed to complete the call.
• Reviews medical records.
• Coordinates with healthcare providers.
• Ensures patients receive appropriate, cost-effective care in accordance with clinical guidelines and insurance requirements.

Skills

• Communication: Strong interpersonal skills to be able to connect with patients, doctors, internal team members, and providers.
• Customer Service: Friendly demeanor and understanding to be able to relay sensitive information to members.
• Detail Oriented: Accuracy and attention to detail when reviewing pre-certifications and plans.

Qualifications

• CNA, LPN, or Medical Assistant preferred.
• Background in patient health support or care.
• 1+ years of experience within this field.

Benefits

• Medical, Dental, Vision Insurance (most benefits start day 1)
• 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

Schedule

• Daytime office hours
• Weekends and holidays off