Utilization Management Specialists- 225668
3 weeks ago
This is a REMOTE opportunity for anyone with Utilization Management experience with benefits and weekly pay
The Utilization Management Specialist implements, maintains and executes procedures and processes by which Optum performs its referral and authorization process. This position responds to inquiries from patients, staff and physicians pertaining to referral authorization questions. The position also researches medical history and diagnostic tests when requested, to assist in review, processing, and coordination of prospective, concurrent and retrospective referrals
Overview Of Responsibilities:
- Initiate Referral Authorizations
- Acquires and maintain a working knowledge of Optum contracted health plans agreements and related insurance products
- Provides administrative and enrollment support for team to meet Company goals
- Gathers information from relevant sources for processing referrals and authorization requests
- Submits authorization & referral requests to healthplan via avenue of insurance requirement.
- Track authorization status inquires for timely response
- Maintains strong understanding of and educate our physicians, clinical teammates, patients and families regarding contracted health plans requirements related to Utilization Management and authorizations.
- Acts as a liaison between providers, teammates, outside vendors, health plans, community services and patients to support Utilization Management process and requirements
- Reviews benefit language and medical records to assist in completion of requested services, to meet health plan requirements
- Documents patient information in the electronic health record following standard work guidelines
- Coordinates with Clinical teammates and health plans to identify patients with Utilization Management needs
- Provides member services to all patient group
- Answers referral and authorization inquiries from health plans, our clinical areas, patients and outside Optum Physician office/facilities
- Assists in the development and implementation of job specific policy and procedures
- Assists in the collection of information for member and/or provider appeals of denied requests
- Identifies areas for potential improvement of patient satisfaction
-
Utilization Management Specialists- 225668
3 weeks ago
Everett, United States Medix™ Full timeThis is a REMOTE opportunity for anyone with Utilization Management experience with benefits and weekly pay!!The Utilization Management Specialist implements, maintains and executes procedures and processes by which Optum performs its referral and authorization process. This position responds to inquiries from patients, staff and physicians pertaining to...
-
Utilization Management Specialists
2 days ago
Everett, United States Medix Full timeThis is a REMOTE opportunity for anyone with Utilization Management experience with benefits and weekly pay!! The Utilization Management Specialist implements, maintains and executes procedures and processes by which Optum performs its referral and authorization process. This position responds to inquiries from patients, staff and physicians pertaining to...
-
Utilization Management Specialists
1 month ago
Everett, United States Medix Full time*Position is fully remote but must reside near Everett, WA* The Utilization Management Specialist implements, maintains and executes procedures and processes by performing its referral and authorization process. This position responds to inquiries from patients, staff and physicians pertaining to referral authorization questions. The position also...
-
Project Management Specialist 4
1 month ago
Everett, United States Boeing Future of Flight Full timeProject Management Specialist 4 (Contract) Contract (5 months 28 days) Published 2 days ago Excel Project Management Powerpoint SharePoint Microsoft Word Work statement is a non-managerial role, non-leadership role. We are Boeing Research & Technology (BR&T): Boeing's global research and development team creating and implementing innovative technologies that...
-
Materials Management Specialist B
7 days ago
Everett, United States The Boeing Company Full timeWork with other Material Management Specialist to ensure that the shop, shop personnel, tool rooms and other customers are supplied with tools, equipment and supplies. Set up and maintain inventory recording and control systems and facilitate/coordin Management, Specialist, Materials, Equipment, Inventory, Manufacturing, Technology, Systems
-
Field Manager
1 day ago
Everett, United States Interior Specialists, Inc Full timeLooking to build your career and design your future? You have come to the right place. Summary Manage the pre-installation readiness, installation, and completion of all trades and projects to include one or more of the following: Flooring, counters, solid surfaces, cabinets, and blinds. The Field Manager will ensure all the work is completed with the...
-
Everett, United States The Boeing Company Full timeLeads supplier/subcontractor business relationships, in-service requirements and performance to contractual obligations and expectations. Manages and monitors supplier quality, delivery, and financial performance. Leads the development of mitigations Management, Specialist, Experience, Supply, Business Services, Technology
-
Utilization Review RN
21 hours ago
Everett, Washington, United States Providence Health & Services Full timeOversee utilization management and review of patients care delivery while in the hospital and provide clinical reviews and denial appeals where appropriate either during admission or post discharge.Providence caregivers are not simply valued – they're invaluable. Join our team at Providence Regional Medical Center Everett and thrive in our culture of...
-
Facilities Project Management Specialist
2 weeks ago
Everett, United States Spectraforce Technologies Full timeFacilities Project Management Specialist Everett WA 12 Months Start Time: 6:30 AM End Time: 3:00 PM This role requires analytical, communication, and time management skills in a fast-paced, collaborative team environment. You will...
-
Customer Success Specialist
3 weeks ago
Everett, United States RANDYS Worldwide Full timeJob Type Full-time Description RANDYS Worldwide is seeking a dynamic and detail-oriented Customer Liaison Specialist to join our team at the Everett, WA Corporate Office. This role will serve as a pivotal link between Finance, Sales, Supply Chain, and our National Customer base, ensuring smooth communication and resolution of issues. Essential Duties &...
-
Customer Success Specialist
1 month ago
Everett, United States RANDYS Worldwide Full timeJob DescriptionJob DescriptionDescription:RANDYS Worldwide is seeking a dynamic and detail-oriented Customer Liaison Specialist to join our team at the Everett, WA Corporate Office. This role will serve as a pivotal link between Finance, Sales, Supply Chain, and our National Customer base, ensuring smooth communication and resolution of issues.Essential...
-
Facilities Project Management Specialist
2 weeks ago
Everett, United States Spectraforce Technologies Full timeFacilities Project Management Specialist Everett WA 12 Months Start Time: 6:30 AM End Time: 3:00 PM This role requires analytical, communication, and time management skills in a fast-paced, collaborative team environment. You will be a key member of an experienced Office Build-up/refresh team that designs, implements, performs infrastructure improvements in...
-
Customer Experience Specialist
1 day ago
Everett, United States Best Buy Full time**Customer Experience Specialist (Advisor) - Job Details** **Customer Experience Specialist (Advisor)** Share Job **Overview** Occasional Seasonal Entry Level Store Associates You are in for some awesome perks (Part-time and Full-time benefits based on your role and tenure) * Backup childcare * Tuition assistance for yourself and dependents * Generous...
-
Everett, United States Clinical Management Consultants Full timeAn award-winning hospital in the Everett, MA area is pursuing an Operating Room Nurse Manager of Neurosurgery to strategically lead and manage their neurology operating room. This is a full-time, permanent role in a fast-paced environment with a dynamic team. Providing personalized patient care to their community nearly 35 years, this highly reputable...
-
Retail Sales Specialist
1 day ago
Everett, United States Spectraforce Technologies Full timeTitle: Retail Sales Specialist Location: Everett, WA 98203 (On site) Duration: 12 Months Job Description Work statement is a non-managerial role, non-leadership role. Regular and predictable attendance is required We are currently looking for a self-motivated individual looking for an opportunity to join our team as a Retail Sales Specialist. Our ideal...
-
Project Management Specialist 4
3 days ago
Everett, United States Chipton-Ross Full timeJob Description Job Description Chipton-Ross is seeking a Project Management Specialist 4 for a contract opportunity in Everett, WA.RESPONSIBILITIES:Client is seeking an experienced Project Manager to join our BCA Production & Industrial Engineering team in Everett, WA. You will work in providing high impact, creative solutions to complex problems that...
-
Retail Sales Specialist
2 weeks ago
Everett, United States Spectraforce Technologies Full timeTitle: Retail Sales Specialist Location: Everett, WA 98203 (On site) Duration: 12 Months Job Description Work statement is a non-managerial role, non-leadership role. Regular and predictable attendance is required We are currently looking for a self-motivated individual looking for an opportunity to join our team as a Retail Sales Specialist. Our ideal...
-
Meter Specialist
19 hours ago
Everett, United States Consolidated Supply Full timeJob Description: The Meter Specialist will support Consolidated Supply by providing metering solutions to optimize the delivery and use of water to cities and municipalities throughout Oregon, Washington, and Idaho. The Meter Specialist will be driving and flying to visit customers on-site and branches approximately 65% of the time. The work days may exceed...
-
Retail Sales Specialist
3 weeks ago
Everett, United States Spectraforce Technologies Full timeTitle: Retail Sales Specialist Location: Everett, WA 98203 (On site) Duration: 12 MonthsJob Description Work statement is a non-managerial role, non-leadership role. Regular and predictable attendance is required We are currently looking for a self-motivated individual looking for an opportunity to join our team as a Retail Sales Specialist. Our ideal Retail...
-
Project Management Specialist 4
4 days ago
Everett, United States Chipton-Ross Full timeJob Description Job Description Chipton-Ross is seeking a Project Management Specialist 4 for a contract opportunity in Everett, WA. RESPONSIBILITIES: Client is seeking an experienced Project Manager to join our BCA Production & Industrial Engineering team in Everett, WA. You will work in providing high impact, creative solutions to complex problems that...