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Healthcare Coordinator

2 months ago

Trenton, New Jersey, United States Evolent Health Full time
About the Role

Evolent Health is seeking a skilled Coordinator, Intake Utilization Management to join our team. As a key member of our Client Services department, you will play a critical role in processing medical treatment requests and ensuring seamless collaboration with our clinical team.

Key Responsibilities
  • Review internal workflows and policies to determine the need for prior authorization reviews or redirects.
  • Enter data into our proprietary system to generate cases for medical and behavioral health reviewers.
  • Work directly with physician's offices to obtain missing information required for prior authorization requests.
  • Submit IT tickets to address barriers to generating cases for clinical review and follow through to completion.
  • Address requests promptly and courteously, honoring commitments and displaying persistence in obtaining necessary information.
  • Meet established Utilization Management Intake Objectives and Key Results.
Requirements
  • A high school diploma or GED is required.
  • 1-3 years of experience in a Coordinator role, requesting or submitting prior authorization requests, and/or relevant healthcare experience in claims or appeal & grievance is required.
  • Previous background or experience with Oncology is preferred.
  • Ability to read, write, and speak English fluently with patients and providers is required.
  • Ability to adapt to fluctuating situations and perform work of a detailed nature, while avoiding errors, is required.
  • Proficient in using computer and Windows PC applications, including strong keyboard and navigation skills, is required.
  • Team-oriented, with a strong work ethic and commitment to productivity, is required.
  • Demonstrated ability to meet established goals while balancing a workload and prioritizing assignments in a remote environment is required.
  • Ability to connect to a router via an Ethernet cord, as our inbound/outbound calls application does not function on Wi-Fi, 4G, 5G, LTE, or Satellite internet services, is required.
About Evolent Health

Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status. We offer comprehensive benefits, including health insurance benefits, to qualifying employees. The expected base salary/wage range for this position is $20/hr, with a bonus component dependent on pre-defined performance factors.