Utilization Management Support Specialist I

Job not on LinkedIn

🔥 13 hours ago

🇺🇸 United States – Remote

💵 $37.7k - $56.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💝 Customer Support

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Magellan Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

💰 $101M Private Equity Round - Magellan Health Services on 2004-01

Healthcare • Healthcare Insurance

Magellan Health is a healthcare organization focused on behavioral health and care-management services. The company provides clinical care managers, military and family life counselors, and behavioral health services across regional programs (e. g. , Magellan Hawai‘i, Magellan of New Mexico), and supports treatment coordination for mental health and substance abuse conditions. It also offers programs that support military families and other institutional clients, indicating work in managed behavioral health and care coordination.

📋 Description

• Assist in the physician advisor process for cases sent for peer-to-peer review • Support scheduling of reviews, communicating results, and completing verbal and written correspondence • Research cases referred to peer review and contact facilities to schedule physician-to-physician reviews • Document task completion in applicable internal systems • Prepare administrative, approval, and clinical denial letters • Review completed denial letters for accuracy, template use, and appropriate grade level • Take calls from the designated phone queue when needed • Identify risk situations and escalate them to the supervisor • Troubleshoot case issues by coordinating with internal departments, team members, and physicians • Consult internal departments to ensure cases meet guidelines • Assist in mentoring and training new UM Support Specialists • Perform additional duties assigned by a leader consistent with the job's intent

🎯 Requirements

• Experience in customer interactions and detailed review of health-related materials • Strong interpersonal skills and attention to detail • Ability to organize work and seek help on tasks where needed • Ability and willingness to learn new software applications • Strong writing and proofreading skills • Experience in Microsoft Office suite applications • Strong time management skills • Strong analytical skills • Required work experience in healthcare • Associate degree in Business Administration preferred

🏖️ Benefits

• May be eligible for short-term incentives • Comprehensive benefits package • Health, life, voluntary and other benefits and perks • Benefits and perks supporting physical, mental, emotional and financial wellbeing • Tobacco-free workplace • Equal Opportunity Employer