Utilization Management Representative
Job Description
- Provide office support for all units within the Utilization Management and Population Health Department
- Assist with incoming authorization requests, data entry of clinical information, and pre-certification requests
- Responsible for clerical support relative to the Bed Day process
- Handle collecting, reporting, clarification, and entry of data, pre- and post-acute certification requests for specific services
- Complete collection of non-clinical data, report generation, health plan coordination for non-clinical issues, and other administrative duties that are required to provide comprehensive coordination of services
- Handle and direct referral status requests received and assist with requesting clinical updates via phone and fax from facilities
- High School Diploma or GED required
- Minimum 2-3 years of managed care experience either in a physician office or hospital setting health plan, ACO or other managed care setting.
- Knowledge of medical terminology, HMO, PPO and referral processes.
- Strong communication skills and time management skills.
- Must be able to pass a pre-employment drug screening and criminal background check
- Located immediately off the highway for easy access
- Minutes away from Pearland Town Center with endless shopping and restaurants
- Work for a healthcare organization that values patient care, customer satisfaction, and a supportive environment
- Work in a clinic to improve the quality and value of healthcare delivered in the community
- During your employment with Team1Medical Staffing, you are eligible to enroll in our benefits program including medical (3 plans to choose from), dental, disability, critical illness, life, vision, accident, and behavioral health insurance. Additional benefits include 401K, direct deposit, and our referral bonus program!
Meet Your Recruiter
Olivia Gonzalez, CHP
Staffing Consultant
Olivia received her bachelor’s in human resources from the University of Houston. She joined Team1Medical in 2021 as a Staffing Consultant working to enrich Houston’s healthcare by matching healthcare organizations and top-notch candidates to offer the best patient care. In November 2022, Olivia earned her Certified Health Care Staffing Professional® (CHP) certification. Trustworthy, compassionate and a detailed-oriented communicator, Olivia wants to help people find a job they love. She believes that people are the most important asset to any organization and her goal is to help our candidates and clients in enriching their careers and internal resources.
In her free time, Olivia is an enthusiast of music, movies and relaxing with family and friends.