Utilization Management Assistant

Job Details Do you want to work at one of the Top 100 Hospitals in the nation? We are guided by our values of Love and Excellence and are passionate about delivering health, not just health care. Come join us at ChristianaCare! Our Utilization Management department located in Wilmington, DE is looking for a full-time Utilization Management Assistant to use internal and external resources to resolve social, emotional, and environmental needs by verifying benefits, obtaining insurance authorizations, placing orders to vendors and accurately entering data into clinical information systems. The ideal candidate will be well organized, detail oriented and can multitask. The candidate is expected to complete tasks and duties within a prescribed timeline. Strong computer skills as well as good verbal and written communication skills are required. Benefits of working at ChristianaCare Generous PTO, Competitive Pay & Robust Benefits Package. 403B company match and Tuition Reimbursement 12 weeks Paid Parental Leave (after one year of service) Responsibilities Perform duties adhering to the ChristianaCare Core Values and Behaviors guided by Excellence and Love. Provides administrative support to the team; assists with copying, faxing, form completion, addressing emails and Medicare letters by department standards. Assists with completion of Utilization Management duties including providing clinical information to insurance companies to obtain authorizations and updating patient records timely. Assists in contacting patient and families to discuss level of care, status changes, and appeal options with insurance. Assist in scheduling phone calls and meetings for members of the UM team with payer representatives. Establish a knowledge base for medical necessity requirements for all major insurance companies. Assists with routine calls, emails, faxes from insurance companies. Assists with general support services and office coverage as staffing needs dictate. Establishes collaborative relationships with Utilization Managers, Care Managers and other health care staff to effectively and efficiently complete necessary services. Enters accurate data, authorization/referral entries into computer system as directed by team in an accurate and timely manner. Calls insurance companies for authorization, benefit verification and coverage information as necessary. Execute proper use of the telephone and voice mail systems. Incorporates services standards for telephone contact into daily activities. Provides superior customer service to providers and members. Communicates effectively with departments in the Christiana Care Health System. Performs specific projects as directed by Supervisor and/or Director. Acquires new skills needed for performing job functions as the healthcare/delivery system changes. Participates as an active member of the team, offering suggestions and recommendations for more effective and efficient operations. Maintains confidentiality of patient information. Participates in seminars/workshops and in-service education regarding new resources. Adheres to Christiana Care policies and procedures including, but not limited to, annual Fire and Safety, Infection Control procedures and demonstrates core values. Perform assigned work safely, adhering to established departmental safety rules and practices. Addresses and/or reports to Managers/Director, in a timely manner, any unsafe activities, conditions, hazards or safety violations that may cause injury to oneself, other caregivers, patients and visitors. Scheduling and calendar management - managing appointments and meetings for leaders. Maintaining organized filing systems, both electronic and physical and retrieving information as needed. Meeting coordination - preparing meeting agendas, taking minutes, and ensuring logistics are handled effectively. Office management - ordering office supplies. Supports the onboarding of new hires by arranging necessary accesses, vocera, IT needs, desk. Monitor IT equipment needs; order necessary equipment; enter IT tickets as needed. Performs other related duties as required. Knowledge, Skill and Ability Requirements Knowledge of ChristianaCare and departmental policies, procedures, and standards. Knowledge of Joint Commission requirements and standards. Proficient with Microsoft Word, Excel, and PowerPoint. Ability to function as a member of an interdisciplinary team. Ability to learn and understand basic medical terminology. Understand HIPAA/Privacy regulations with patient medical records. Knowledge of PC including EMR applications. Typing proficiency. Strong organization and superior communication skills are required. Knowledge of the insurance authorization process is preferred. Ability to use telephone communication systems. Ability to orally communicate, effectively. Ability to identify issues, troubleshoot problems and find effective solutions. Ability to adapt to changing priorities and manage multiple tasks simultaneously. Office Hours: Day Shift Qualifications High School diploma or equivalent required. Four years progressively responsible administrative support to an administrator or manager. Five years of experience in a support role in Case Management/Utilization Management experience preferred. Five years of experience in administrative support in Health Care preferred. Special Requirement: Stability to work under emotional, time, and volume pressure. Physical Demands Intermittent sitting, standing, and lifting. Capable of getting from and to nursing units and other areas of the facilities as required. Working Conditions Occasional contacts with patients who have a communicable disease or who may behave violently. Hospital office space. Hourly Pay Range: $22.29 - $33.44. This pay rate/range represents ChristianaCare's good faith and reasonable estimate of compensation at the time of posting. The actual salary within this range offered to a successful candidate will depend on individual factors including without limitation skills, relevant experience, and qualifications as they relate to specific job requirements. EEO Statement Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation. #J-18808-Ljbffr Christiana Care Health System