Utilization Management Representative II
2 weeks ago
Anticipated End Date: Position Title Utilization Management Representative II Job Description Utilization Management Representative II is responsible for managing incoming calls, including triage, opening of cases and authorizing sessions. Location This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered unless an accommodation is granted as required by law. Hours Monday through Friday 8:30 AM to 5 PM Pacific How you will make an impact Managing incoming calls from clients needing mental health and substance use services. Determines contract and benefit eligibility; provides referral authorization for outpatient services. Obtains intake (demographic) information from caller. Conducts a thorough radius search in Provider Finder and follows up with provider on referrals given. Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. Processes incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and complex requests for services. Verifies benefits and/or eligibility information. May act as liaison between Medical Management and internal departments. Responds to telephone and written inquiries from clients, providers and in-house departments. Conducts clinical screening process. Minimum Requirements Requires HS diploma or equivalent and a minimum of 2 years customer service experience in a healthcare related setting and medical terminology training; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities, and Experiences Strong oral, written, and interpersonal communication skills; problem‑solving, facilitation, and analytical skills. Bachelor’s degree preferred. Bilingual in Spanish preferred. Experience working in the mental health field preferred. Salary and Benefits For candidates working in person or virtually in the below locations, the salary* range for this specific position is $19.86 to $31.09. Locations: California. In addition to your salary, Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution (subject to eligibility). Job Level Non-Management, Non-Exempt Workshift Not specified. Job Family CUS > Care Support Equal Employment Opportunity Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. #J-18808-Ljbffr
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Utilization Management Representative II
2 weeks ago
Walnut Creek, United States Elevance Health Full timeAnticipated End Date: 2026-01-24 Position Title Utilization Management Representative II Job Description Utilization Management Representative II is responsible for managing incoming calls, including triage, opening of cases and authorizing sessions. Location This role enables associates to work virtually full-time, with the exception of required in-person...
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Utilization Management Representative II
2 weeks ago
Walnut Creek, CA, United States Elevance Health Full timeUtilization Management Representative II A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and...
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Remote Utilization Management Specialist II
2 weeks ago
Walnut Creek, United States Elevance Health Full timeA healthcare company is looking for a Utilization Management Representative II to manage incoming calls related to mental health and substance use services. The candidate should have a high school diploma and at least two years of customer service experience in a healthcare setting. The role offers virtual work flexibility with required in-person training....
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Remote Utilization Management Specialist II
2 weeks ago
Walnut Creek, United States Elevance Health Full timeA healthcare company is looking for a Utilization Management Representative II to manage incoming calls related to mental health and substance use services. The candidate should have a high school diploma and at least two years of customer service experience in a healthcare setting. The role offers virtual work flexibility with required in-person training....
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Utilization Management Representative I
3 weeks ago
Walnut Creek, United States Elevance Health Full timeUtilization Management Representative I role at Elevance Health . Base pay range $17.87/hr - $27.97/hr Location This role enables associates to work virtually full‑time, with required in‑person training sessions. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered unless an accommodation is granted as...
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Utilization Management Representative I
3 weeks ago
Walnut Creek, United States Elevance Health Full timeUtilization Management Representative I role at Elevance Health. Base pay range $17.87/hr - $27.97/hr Location This role enables associates to work virtually full‑time, with required in‑person training sessions. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered unless an accommodation is granted as...
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Remote Utilization Management Associate I
3 weeks ago
Walnut Creek, United States Elevance Health Full timeA healthcare company is seeking a Utilization Management Representative I for a full-time position. Responsibilities include managing incoming calls, determining benefit eligibility, and conducting clinical screenings. Ideal candidates should possess a high school diploma or equivalent with at least one year of customer service or call-center experience....
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Remote Utilization Management Associate I
3 weeks ago
Walnut Creek, United States Elevance Health Full timeA healthcare company is seeking a Utilization Management Representative I for a full-time position. Responsibilities include managing incoming calls, determining benefit eligibility, and conducting clinical screenings. Ideal candidates should possess a high school diploma or equivalent with at least one year of customer service or call-center experience....
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Consultant, Environmental Planner Utilities
1 week ago
Walnut Creek, United States Environmental Resources Management Full timeConsultant, Environmental Planner Utilities & Vegetation Management - Northern California page is loaded## Consultant, Environmental Planner Utilities & Vegetation Management - Northern Californialocations: Walnut Creek, California: Sacramento, Californiatime type: Full timeposted on: Posted Todayjob requisition id: R00028576**ERMs** fastest-growing global...
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Consultant, Environmental Planner – Utilities
20 hours ago
Walnut Creek, United States Environmental Resources Management (ERM) Full timeConsultant, Environmental Planner – Utilities & Vegetation Management - Northern California page is loaded## Consultant, Environmental Planner – Utilities & Vegetation Management - Northern Californialocations: Walnut Creek, California: Sacramento, Californiatime type: Full timeposted on: Posted Todayjob requisition id: R **ERM’s** fastest-growing...
