Utilization Manager Jobs in Delaware (NOW HIRING)

Do you want to work at one of the Top 100 Hospitals in the nation? We are guided by our values ofLoveandExcellenceand are passionate about delivering health, not just health care. Come join us at ChristianaCare!

Our Utilization Management departmentlocated 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. Candidate to complete tasks and duties within a prescribed timeline. Strong computer skills as well as good verbal and written communication skills.

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)

The responsibilities of the Utilization Management Assistant will include;

• 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 HIPPA/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.

About ChristianaCare

ChristianaCare was recognized as one of "America's 100 Best Hospitals" by Healthgrades, selected as one of the Most Wired Hospitals in the US by the American Hospital Association, and ranked by US News & World Report as the #3 'Best Hospital' in the Philadelphia region out of more than 90 hospitals. To learn more click on this linkhttps://www.youtube.com/watch?v=AZtpU0ib3t8

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.

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.

Post End Date

EEO Posting Statement

ChristianaCare offers a competitive suite of employee benefits to maximize the wellness of you and your family, including health insurance, paid time off, retirement, an employee assistance program. To learn more about our benefits for eligible positions visithttps://careers.christianacare.org/benefits-compensation/