Utilization Management Asst
3 weeks ago
Job Title: Utilization Management Assistant Job Specialty: Medical Management Job Duration: 13 weeks Shift: Hybrid - Day shift (8:00 am to 5:00 pm or 8:30 am to 5:30 pm or 9:00 am to 6:00 pm) Guaranteed Hours: 40.00 per week Experience: Previous experience in managed care, especially in a medical management department, claims, or member service. Health care setting experience is a plus. License: Not required Certifications: Not required Must-Have: High school diploma or equivalent, excellent customer service skills, and phone etiquette. Ability to operate PC, Windows, Word, fax machine, photocopier, computer, and multi-line telephone.Job Description:- Process initial incoming faxes or phone requests into the intake department.- Gather demographic and benefit data and document it in the appropriate system.- Adhere to time frames and turnaround times, reflected in inter-rater reliability reviews.- Route and evaluate all calls and faxes to assign as necessary to other staff.- Perform data entry of authorization information into systems, fax information to originating physician, facility, or specialist.- Implement nuances of product line and regulatory requirements in processing all authorization requests, including notification requirements.- Confirm eligibility for requested authorizations and request membership identification numbers for newborns.- Utilize resources available from state agencies; references may be made by phone or online.- Assist with the complaint and appeal process regarding eligibility/claims and document appropriately in the utilization management system.- Handle a high volume of calls, prioritize work, be flexible, and perform as a team member.- Apply ICD and CPT coding skills (preferred) and knowledge of medical terminology, ICD 10 & CPT coding, and place of service knowledge.- Previous health plan experience is preferred.- Typing and data entry skills are required.- Customer service experience is preferred.
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Utilization Management Asst
2 weeks ago
Bellaire, United States Texas Children's Hospital Full timePride Health is hiring a Utilization Management Asst for one of its clients in Houston, TX.This is a 3 +month contract with a possible extension with competitive pay and benefits. Job Title- Utilization Management AsstLocation - Houston, TX Pay range - $20 - $24 per hour on W2.Length of assignment - 3 months + possible extensionShift - Hybrid- Day shift 8:00...
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Utilization Management Asst
3 weeks ago
Bellaire, United States Integrated Resources Full timeJob Title: Utilization Management Assistant Job Location: Bellaire, TX Job Duration: 03+ Months Shift : Morning shift Roles and responsibilities: Primarily responsible for processing initial incoming faxes or phone requests into the intake department Gathering demographic and benefit data and documenting in appropriate system. This is determined...
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Clinical Utilization Manager
1 month ago
Bellaire, Texas, United States Texas Children's Hospital Full timeJob Title: Utilization Management Clinical RNWe are seeking a skilled Utilization Management Clinical RN to join our team at Texas Children's Hospital. As a Utilization Management Clinical RN, you will play a critical role in ensuring that our patients receive the most appropriate and cost-effective care.Responsibilities:Analyze submitted information,...
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Clinical Utilization Manager
1 month ago
Bellaire, Texas, United States Texas Children's Hospital Full timeJob Title: Utilization Management Clinical RNWe are seeking a skilled Utilization Management Clinical RN to join our team at Texas Children's Hospital. As a key member of our healthcare team, you will play a critical role in ensuring that our patients receive the most appropriate and cost-effective care.Responsibilities:Analyze submitted information,...
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Utilization Management Specialist
3 weeks ago
Bellaire, Texas, United States Texas Children's Health Plan Full timeJob Title: Utilization Management AssistantJob Specialty: Medical ManagementJob Duration: 13 weeksShift: Hybrid - Day shift (8:00 am to 5:00 pm or 8:30 am to 5:30 pm or 9:00 am to 6:00 pm)Guaranteed Hours: 40.00 per weekExperience: Previous experience in managed care, especially in a medical management department, claims, or member service. Health care...
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Utilization Management Specialist
2 weeks ago
Bellaire, Texas, United States Texas Children's Hospital Full timeJob Title: Utilization Management SpecialistLocation: Houston, TXJob Type: ContractDuration: 3+ monthsPay: $20-$24 per hourJob Description:We are seeking a skilled Utilization Management Specialist to join our team at Texas Children's Hospital. As a Utilization Management Specialist, you will be responsible for processing initial incoming faxes or phone...
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Utilization Management Coordinator
3 weeks ago
Bellaire, Texas, United States Integrated Resources Full timeJob Title: Utilization Management AssistantAt Integrated Resources, we are seeking a highly skilled Utilization Management Assistant to join our team.Job Summary:We are looking for a detail-oriented and organized individual to assist with the processing of initial incoming faxes or phone requests into the intake department. The successful candidate will be...
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Utilization Management Assistant
2 weeks ago
Bellaire, Texas, United States Integrated Resources Full timeJob Title: Utilization Management AssistantJob Summary:We are seeking a highly skilled Utilization Management Assistant to join our team at Integrated Resources. As a key member of our healthcare operations team, you will be responsible for processing initial incoming faxes or phone requests into the intake department. Your primary duties will include...
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Clinical Utilization Management RN
4 weeks ago
Bellaire, Texas, United States Texas Children's Hospital Full timeJob Title: Utilization Management Clinical RNWe are seeking a skilled Utilization Management Clinical RN to join our team at Texas Children's Hospital. As a Utilization Management Clinical RN, you will play a critical role in ensuring that our patients receive the most appropriate and cost-effective care.Key Responsibilities:Analyze submitted information,...
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Clinical Utilization Management RN
1 month ago
Bellaire, Texas, United States Texas Children's Hospital Full timeJob Title: Utilization Management Clinical RNWe are seeking a skilled Utilization Management Clinical RN to join our team at Texas Children's Hospital. As a Utilization Management Clinical RN, you will play a critical role in ensuring that our patients receive the most appropriate and cost-effective care.Key Responsibilities:Analyze submitted information,...
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Clinical Utilization Manager RN
3 weeks ago
Bellaire, Texas, United States Texas Children's Hospital Full timeUtilization Management Clinical RNWe are seeking a skilled Utilization Management Clinical RN to join our team at Texas Children's Hospital. In this role, you will play a critical part in ensuring the efficient use of healthcare resources while maintaining high-quality patient care.Key Responsibilities:Analyze submitted information, including clinical...
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Utilization Management Clinical RN
1 month ago
Bellaire, United States Texas Children's Hospital Full timeJob DescriptionWe are searching for a Utilization Management Clinical RNsomeone who works well in a fast-paced setting. In this position, you will provide precertification of inpatient hospitalizations and all outpatient procedures and services requiring authorization. This role performs telephonic and/or concurrent review of inpatient hospitalizations and...
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Utilization Management Clinical RN
6 days ago
Bellaire, United States Allyon Full timeSummary: Allyon, Inc. is an established IT and Healthcare Services firm and we love what we do! It makes our day when we are able to help talented individuals achieve their career goals while a the same time helping our clients build quality teams. If you are interested in joining the Allyon Team, please apply or submit your resume for review today! Job...
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Utilization Management Clinical RN
2 months ago
bellaire, United States Texas Children's Hospital Full timeUtilization Management Clinical RNWe are searching for a Utilization Management Clinical RN -- someone who works well in a fast-paced setting. In this position, you will provide precertification of inpatient hospitalizations and all outpatient procedures and services requiring authorization. This role performs telephonic and/or concurrent review of inpatient...
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Clinical Utilization Management RN
3 weeks ago
Bellaire, Texas, United States Texas Children's Hospital Full timeAbout the RoleWe are seeking a skilled Clinical Utilization Management RN to join our team at Texas Children's Health Plan. As a Clinical Utilization Management RN, you will play a critical role in ensuring that our members receive the most appropriate and cost-effective care possible.Key ResponsibilitiesAnalyze submitted information, including clinical...
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Healthcare Utilization Specialist
2 weeks ago
Bellaire, Texas, United States Integrated Resources Full timeJob Title: Healthcare Utilization SpecialistJob Summary:Integrated Resources is seeking a skilled Healthcare Utilization Specialist to join our team. As a key member of our medical management department, you will be responsible for processing initial incoming faxes or phone requests into the intake department. Your primary duties will include gathering...
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Case Manager
2 weeks ago
Bellaire, United States Memorial Hermann Health System Full timeAt Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed...
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Nurse Case Manager
3 weeks ago
Bellaire, Texas, United States Texas Children's Hospital Full timeJob Title: Pediatric Case Manager RNWe are seeking a highly skilled Pediatric Case Manager RN to join our team at Texas Children's Hospital. As a key member of our healthcare team, you will play a vital role in ensuring the optimal health and well-being of our patients.Responsibilities:Conduct comprehensive assessments of patients' biophysical, psychosocial,...
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Medical Management Assistant
2 weeks ago
Bellaire, Texas, United States Texas Children's Health Plan Full timeJob Title:Medical Management Assistant Job Specialty:Healthcare Operations Job Duration: 13 weeks Shift: Hybrid - Day shift (8:00 am to 5:00 pm or 8:30 am to 5:30 pm or 9:00 am to 6:00 pm)Guaranteed Hours: 40.00 per week Experience: Previous experience in managed care, especially in a medical management department, claims, or member service. Healthcare...
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Nurse Case Manager
3 weeks ago
Bellaire, Texas, United States Texas Children's Hospital Full timeJob SummaryWe are seeking a skilled Registered Nurse Case Manager to join our team at Texas Children's Health Plan. As a key member of our care management team, you will play a vital role in coordinating and managing the care of high-risk members to ensure optimal outcomes.Key ResponsibilitiesConduct comprehensive assessments of members' biophysical,...