Utilization Management Assoc

2 months ago

Wethersfield, United States Hartford Healthcare Full time

Description

Job Schedule: Full Time
Standard Hours: 40
Job Shift: Shift 1
Shift Details: 8:00am to 4:30pm with rotation Sunday shifts

Work where every moment matters.

Every day, over 30,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticuts most comprehensive healthcare network.

The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization.


With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.

Integrated Care Partners (ICP) is a physician-led, clinically integrated health care network whose mission is to assist our members in providing the highest quality care at the most reasonable cost for our patients in the current, rapidly changing medical environment.

Position Summary:

The Clinical Resource
Management Associate is an integral part of the Care Management team. The Clinical
Resource Management Associates focus is on providing support and coordination
of utilization management services for the utilization management department.

Position Responsibilities:

  1. Monitors
    and manages assigned utilization management reports, including the Payer End of
    Day report, Utilization Management list, Discharge Log, and the Discharge
    Disposition report for payers.

  2. Monitors
    and manages assigned EPIC work queues.

  3. Updates EPIC with authorization and denial information.

  4. Provides
    the Clinical Resource Management Nurse with support for denials, appeals, and
    physician advisor communication.

  5. Retrieves,
    manages and/or triages department phone calls, voicemails, fax requests and
    Tiger Texts.

  6. Communicates
    with payers, case management, medical records, and other departments.

  7. Scans
    and uploads documentation into the electronic health records.

  8. Performs
    routine and administrative tasks within the scope of non-licensed personnel.

  9. Manages Certification Email process.

  10. Other duties as assigned by supervisor

Qualifications

Education: High
School Diploma, Medical Administrative
Assistant certification preferred
Experience:

Two+ years
professional work experience in health care, managed care, or insurance.

Knowledge, Skills and Ability Requirements:

  • Strong
    interpersonal and communication skills

  • Effective time
    management skills, able to work in a fast-paced environment with changing
    priorities

  • Effective organizational
    skills

  • High
    level understanding of confidentiality and HIPAA requirements

We take great care of careers.

With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.

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