Hybrid Long Term Services & Support Utilization Management Technician Senior presso AmeriHealth Caritas

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Responsibilities:

The Utilization Management Technician Sr. functions under the direction of the Supervisor to coordinate, generate and track both incoming and outgoing correspondence, faxes and authorizations related to prospective, concurrent and post service review functions. Interacts with facilities, vendors, providers, and other staff to facilitate receipt of information, and /or records for prompt review and response.  The Utilization Management Technician Sr. also performs the following:

• Is responsible for assisting the supervisor in the daily operation of the assigned area. 
• Responsible for training and mentoring new and existing associates utilizing UM departmental training guides and tools.  
• May participate in workflow development, training and implementation for the UM Technician associates. 
• Performs and remains knowledgeable in all workflow and timeliness requirements for all areas in Utilization Management.
• Performs non-clinical duties outside the standard UM Technician role as assigned by the UM Supervisor as needed.

Education/Experience:

• High School Diploma required.
• Strongly prefer medical assistant, home health aide, nursing assistant, or other similar health care para-professional training or certification.
• Medical Terminology highly recommended.
• Prior member service or customer service telephone experience desired.
• Certification as a para-professional, medical assistant, home health aide, or nursing assistant a plus.
• Valid driver’s license with car insurance.
• 3-5 years UM Tech, Medical office and or Managed Care experience.
• Proficiency with Microsoft Office Suite (Word, Excel, Power Point).
• Consistent word processing speed and accuracy of 50 or more words per minute.
• Proven proficiency in UM Tech role and expertise with medical management data system.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.