Coordinator, UM Intake

🕒 May 27

🏄 California – Remote

🏄 California – Remote

💵 $18 - $20 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

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Evolent

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Evolent partners with health plans and providers to achieve better outcomes for people with complex health conditions. Working across multiple medical specialties and primary care, we seek to ensure that care plans align with clinical evidence, respect members’ goals and preferences, and connect seamlessly across providers and settings. We believe that every person deserves the same level of care and compassion we would want for our loved ones.

📋 Description

• Serve as a point of contact for processing prior authorization requests in accordance with departmental policies, regulatory requirements, and client contractual agreements. • Reviewing internal workflows and policies to determine if submitted requests require a prior authorization review or redirect as required. • Entering data into a proprietary system generates cases for both the medical and behavioral health reviewers. • Working directly with physician’s offices to obtain missing information required to submit a prior authorization request. • Submitting IT tickets to address barriers to generating cases for clinical review and following the ticket through to completion. • Addressing requests promptly and courteously, honoring commitments, and displaying persistence in obtaining necessary information to address issues and problems. • Meeting established Utilization Management Intake Objectives and Key Results.

🎯 Requirements

• A high school diploma or GED - Required • 1 – 3 years of experience in a Coordinator role either requesting or submitting prior authorization requests. Or relevant health care experience in claims or appeal & grievance. Required • Previous background/experience with Oncology. • Ability to read, write, and speak the English language fluently with patients and providers. - Required • Ability to adapt to fluctuating situations and perform work of a detailed nature, while avoiding errors. - Required • Proficient in using computer and Windows PC applications, which includes strong keyboard and navigation skills. - Required • Team-oriented demonstrates a strong work ethic and is committed to productivity. - Required • Demonstrated ability to meet established goals while balancing a workload and prioritizing assignments in a remote environment. - Required

🏖️ Benefits

• health insurance benefits