Utilization Management Technician

Job Details: Job Location: 7300 Alma Drive

• Plano, TX, Position Type: Full Time, Education Level: High School, Salary Range: $17.31Hourly, The Utilization Management Technician provides support to the Utilization Management Department. Performance requires accuracy, attention to detail, initiative, and pro-active approach to duties and responsibilities. The UM Technician works with other support workforce members, and clinical and medical workforce members within a trauma informed and person driven care model to:
• Process and track Utilization Management related issues in accordance with the Managed Care Organization's guidelines for entering and tracking authorizations, processing completed clinical assessments, and researching denial issues.
• Responsible for the timely and accurate tracking and entering of service authorizations, including insuring service authorization requests are sent to applicable payers in accordance with UM guidelines.
• Assist in preparation of regularly scheduled UM/QM reports, as well as reconciling and tracking data from multiple reports, communicating with applicable parties as needed.
• Prepare and modify documents including correspondence, reports, drafts, memos and emails.
• Assist in case closures and discharge workflow process.
• Complete data entry from state database into electronic medical record for clients.
• Performs other related job duties as assigned.

Qualifications

Education, Training, & Experience

• High school diploma or equivalent (GED).
• Required 2 years’ experience in a medical office setting. Knowledge, Skills, & Abilities
• Basic knowledge of managed care environment.
• Proficient in MS Office with expertise in Microsoft Word, Excel, and PowerPoint.
• Self-starter who consistently meets deadlines, can prioritize, multi-task and be flexible.
• Excellent organizational skills with the ability to prioritize multiple projects.
• Good research skills and attention to detail.
• Ability to write routine reports and correspondence and communicate effectively orally and in writing with a variety of professionals and individuals receiving services/family members.
• Ability to deal with problems involving several concrete variables in standardized situations.