Lead Utilization Management Specialist opportunity in Everett. The Everett Clinic, a part of Optum, offers excellent benefits including free onsite parking, retirement savings plan, tuition reimbursement, paid time off and holidays, health insurance and professional growth opportunities. Our Lead Utilization Management Specialist position functions as an integral member of the healthcare team by leading our Care Coordination team and supporting the referral and authorization processes throughout the clinics. Lead Utilization Management Specialist responsibilities include Coordinates Daily Management for work teams including visibility board updates, productivity stats, level loading assigned tasks to demand, and distributing pull system assignments. Serves as a role model in meeting and exceeding stats, attendance, punctuality and professionalism. Is a leader and resource person within the department and is flexible with their work schedule, including working weekends as need arises. Is a subject matter expert in the work of their group. Responds to inquiries from patients, staff and physicians pertaining to manager care benefits and referral authorization status. Sends out confirmation and denial letters dictated by health plan guidelines. Researches medical history and diagnostic tests to assist in reviewing referrals. Preferred Experience and Credentials Education High School Diploma, or GED required. Associates or higher education preferred. Experience Minimum of two (2) years' experience in health care, including understanding of health plan related operations. Experience in Utilization Management is preferred CertificateLicense Certification from WA State Department of Health as a Medical Assistant-Certified preferred. Certified Professional Coder (CPC) or equivalent preferred. If you need to enter a work site for any reason, you will be required to screen for symptoms using ProtectWell mobile app, Interactive Voice Response ( i.e. entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking order. Schedule 40 hours a week, Monday through Friday, from 830am until 5pm. The Everett Clinic, a part of Optum, offers excellent benefits including free onsite parking, retirement savings plan, tuition reimbursement, paid time off and holidays, health insurance and professional growth opportunities. Interested in learning more? Let's talk about our Utilization Management Specialist opportunities and your career growth! Careers with Optum. Hereaposs the idea. We built an entire organization around one giant objective make health care work better for everyone. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Here you'll find incredible ideas in one incredible company and a singular opportunity to do your lifeaposs best work.(SM) Diversity creates a healthier atmosphere Optum and its affiliated medical practices are Equal Employment OpportunityAffirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Optum and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Posting ID: 601422804Posted: 2021-01-22