Utilization Management Specialists
3 weeks ago
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 researches medical history and diagnostic tests when requested, to assist in review, processing, and coordination of prospective, concurrent and retrospective referrals.
Overview Of Responsiblities:
- 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
- Referrals / Pre-Auth experience
- Logging onto Payer Portals (Availity, OWCP, SAW, etc.)
- Benefit eligibility check experience
- Tech Savvy
- Excellent Communication Skills
Schedule/Shift: Monday-Friday from 8:30-5pm - Remote
-
Utilization Management Specialists- 225668
4 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- 225668
2 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- 225668
2 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...
-
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
-
Facilities Project Management Specialist
6 days 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
4 weeks 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...
-
Customer Success Specialist
2 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 &...
-
Facilities Project Management Specialist
3 days 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...
-
Marketing Specialist
6 days ago
Everett, United States County of Snohomish Washington Full timeDevelops and implements successful marketing plans, strategies and tactics that meet short-term and long-term promotional, financial, and operational objectives. Job Duties STATEMENT OF ESSENTIAL JOB DUTIES Identifies prospective partners, develo Marketing Specialist, Marketing, Specialist, Social Media, Project Management, Business Services, Promotions
-
Payroll Specialist
5 days ago
Everett, United States TERRA Staffing Group Full timeWe're seeking an Entry Level Payroll Specialist to join our dynamic team at our Corporate HQ in Everett! Our diverse clientele spans from local gems to global giants, united by their pursuit of excellence, and we're on the lookout for someone who shares that passion. As an Entry Level Payroll Specialist, your responsibilities will include meticulous...
-
Supply Chain Management Specialist
4 days ago
Everett, United States LanceSoft Full timeJob Details: Job Title: Supply Chain Management Specialist Duration: 12+ Months Location: Everett, WA Job Description: Provide data analysis using techniques from a range of disciplines, to describe, predict, and help supply chain make effective business decisions that improves business performance. Develop and execute inventory control methods and reports...
-
Retail Sales Specialist
1 week 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...
-
Retail Sales Specialist
2 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...
-
Associate Retail Sales Specialist
6 days ago
Everett, United States The Boeing Company Full timeExecutes all incoming and outgoing store logistics, including incoming freight, customer shipping, and inventory operations. Processes freight and complete markdowns. Plays a pivotal role in executing strategic business initiatives, working cross-fun Retail Sales, Sales Specialist, Associate, Retail, Sales Manager, Specialist, Technology
-
Retail Sales Specialist
1 week ago
Everett, United States SPECTRAFORCE Full timeTitle: Retail Sales SpecialistLocation: Everett, WA 98203 (On site)Duration: 12 MonthsJob DescriptionWork statement is a non-managerial role, non-leadership role.Regular and predictable attendance is requiredWe are currently looking for a self-motivated individual looking for an opportunity to join our team as a Retail Sales Specialist. Our ideal Retail...
-
Development Specialist
4 days ago
Everett, United States Insight Global Full timeTitle: Employee Development SpecialistDuration: 3-month Contract w/ extensions likelyLocation: Everett, Onsite Monday-FridayShift: 6am-2:30pm Must Haves:• 3-5 years of experience in Aerospace (Structures, QA, Electrical, Mechanical etc)• Experience in instructing/training (speaking in front of 25 or more)• Proficient in MS Office (Word, Excel,...
-
Development Specialist
3 days ago
Everett, United States Insight Global Full timeTitle: Employee Development SpecialistDuration: 3-month Contract w/ extensions likelyLocation: Everett, Onsite Monday-FridayShift: 6am-2:30pm Must Haves:• 3-5 years of experience in Aerospace (Structures, QA, Electrical, Mechanical etc)• Experience in instructing/training (speaking in front of 25 or more)• Proficient in MS Office (Word, Excel,...
-
Development Specialist
1 day ago
Everett, United States Insight Global Full timeTitle: Employee Development Specialist Duration: 3-month Contract w/ extensions likely Location: Everett, Onsite Monday-Friday Shift: 6am-2:30pm Must Haves: 3-5 years of experience in Aerospace (Structures, QA, Electrical, Mechanical etc) Experience in instructing/training (speaking in front of 25 or more) Proficient in MS Office (Word, Excel,...
-
Retail Sales Specialist
1 week ago
Everett, United States SPECTRAFORCE Full timeTitle: Retail Sales SpecialistLocation: Everett, WA 98203 (On site)Duration: 12 Months Job DescriptionWork statement is a non-managerial role, non-leadership role.Regular and predictable attendance is requiredWe are currently looking for a self-motivated individual looking for an opportunity to join our team as a Retail Sales Specialist. Our ideal Retail...
-
Retail Sales Specialist
1 week ago
Everett, United States SPECTRAFORCE Full timeTitle: Retail Sales SpecialistLocation: Everett, WA 98203 (On site)Duration: 12 Months Job DescriptionWork statement is a non-managerial role, non-leadership role.Regular and predictable attendance is requiredWe are currently looking for a self-motivated individual looking for an opportunity to join our team as a Retail Sales Specialist. Our ideal Retail...