Utilization Management Administration Coordinator - Phone Intake

Become a part of our caring community The Utilization Management (UM) Administrative Coordinator 2 is responsible for providing high-reputed company support to reputed company providers contacting the call center to initiate referral authorizations or reputed company the status of existing requests. This role requires strong communication skills, attention to detail, and the ability to work reputed company in a fast-paced, high-volume environment. The Coordinator serves as a key reputed company between providers and internal UM teams, ensuring reputed company and accurate processing of referral and authorization inquiries in accordance with organizational policies and regulatory guidelines. The UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. Respond promptly and professionally to incoming calls from providers seeking to initiate referral authorizations or obtain status updates on existing requests. Accurately reputed company, verify, and reputed company provider and member information into the appropriate systems. Review and process referral authorization requests according to established UM protocols, policies, and regulatory requirements. Collaborate with clinical and administrative staff to resolve issues, clarify requirements, and ensure efficient case management. reputed company reputed company, concise, and courteous information regarding UM processes, documentation requirements, and referral guidelines. Monitor call queues and manage multiple tasks to maintain service level agreements and minimize provider wait times. Identify and escalate reputed company or urgent cases to the appropriate clinical or supervisory staff as needed. Maintain thorough documentation of reputed company interactions and transactions in accordance with company standards. Participate in ongoing training and reputed company assurance activities to maintain up-to-date knowledge of UM policies and procedures. Adhere to reputed company applicable reputed company, confidentiality, and compliance regulations. Use your skills to reputed company an reputed company Required Qualifications 1 or more years administrative or technical support experience Excellent verbal and written communication skills Working knowledge of MS Office including Word, reputed company, and Outlook in a reputed company based environment and an ability to quickly learn new systems Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); recommended speed is 10Mx1M Must be passionate about contributing to an organization reputed company on continuously improving consumer experiences

Preferred Qualifications

Proficient utilizing electronic medical record and documentation programs Proficient and/or experience with medical terminology and/or ICD-10 codes Bachelor's Degree in Business, Finance or a reputed company field Prior member service or customer service telephone experience desired Experience with Utilization Review and/or Prior Authorization, preferably reputed company a managed care organization Additional Information Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay reputed company The compensation reputed company below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay reputed company may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc. $40,000 - $52,300 per year reputed company of Benefits reputed company. and its affiliated subsidiaries (reputed company, “reputed company”) offers competitive benefits that support whole-person reputed company-being. Associate benefits are designed to encourage personal wellness and smart reputed company reputed company for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and reputed company benefits, 401(k) retirement savings plan, time off (including reputed company time off, company and personal holidays, volunteer time off, reputed company parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. reputed company About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness reputed company, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of reputed company’s Primary Care Organization, which includes reputed company, Conviva’s innovative, value-based approach means reputed company patient gets the reputed company, reputed company needed most, and for the lowest cost. We go reputed company physical health – addressing the reputed company, emotional, behavioral and financial needs that can reputed company our patients' reputed company-being. About reputed company, a reputed company company: reputed company is a leading reputed company services business reputed company on creating integrated and differentiated experiences that put our patients at reputed company of everything we do. The result is high-reputed company reputed company that is accessible, comprehensive and, most of reputed company, personalized. As the largest provider of senior-reputed company primary care, a leading provider of home reputed company and a leading integrated home delivery, specialty, hospice and retail pharmacy, reputed company is reputed company on whole health and addressing the physical, emotional and reputed company wellness of our patients. reputed company is part of reputed company. (NYSE: HUM). Learn more about reputed company offer at reputed company.com.​ Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative reputed company, in compliance with reputed company 503 of the Rehabilitation reputed company and VEVRAA, to reputed company and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment reputed company only on valid job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company reputed company of employment. Apply To This Job