Utilization Review Assistant Jobs in Utah (NOW HIRING)

Job Description:

The Care Management Assistant is a patient-focused role that manages and optimizes patient care in collaboration with nurses and social work care managers, often serving as a bridge between patients, their support people, and the healthcare team. Their responsibilities encompass a range of tasks, including coordinating appointments, facilitating communication with physicians and families, educating patients about available resources, and educating patients and families while delivering regulatory or payer notifications.

Posting Specifics
Shift: Monday - Friday from 8 - 4:30pm; partially remote
Full-time (40 hrs.)
Benefits Eligible: Yes

Essential Functions

• Serves as a liaison between the department and external organizations or individuals, including payers, physicians, post-acute agencies, patients, patient, patient representatives, and other departmental stakeholders.
• Receives and prioritizes requests and transmits clinical information for service authorizations in accordance with contractual requirements and communicates with care managers, utilization review RNs, revenue cycle, and payers as needed to coordinate processes and research payment sources.
• Monitors the status of referrals and maintains ongoing communication.
• Requests and retrieves medical records from Health Information Management for retrospective utilization review or quality assurance.
• Delivers routine regulatory notices to patients within the required timeframes, ensuring proper documentation to support the delivery of government-mandated forms or payer communication.
• Performs clerical tasks to support care management services, including preparing and printing reports, scheduling appointments, distributing and communicating requests, retrieving message (phone, fax, email, and mail), and scanning or copying documents as needed.
• Supports advanced care planning by delivering advance directive information and notarizes documents upon request.
• Supports a compliant patient choice process by ensuring provider lists are current across all systems, distributing them to patients and families as instructed, prior to the patient choice consultation conducted by the care manager or social worker.
• Aids in transition planning by preparing transfer packets, arranging transportation, updating resources on the Integrated Care Management website, and coordinating with patients, families, and next-level providers. Collaborates with care managers to navigate and refer patients to community resources that address social determinants of health.
• Work closely with care managers and clinical teams to ensure patients receive comprehensive and coordinated care. Contribute, in collaboration with Care Management, to the monitoring and success of patient care plans and the resolution of identified social needs.

Skills

• Referral Management
• Patient Advocacy
• Care Coordination
• Communication
• Prioritization
• Compliance Documentation
• Organization
• Problem Solving
• Community Resource Navigation
• Electronic Medical Record Documentation

Minimum Qualifications

• Demonstrated healthcare experience in a clinic or hospital setting.
• Demonstrated customer service with a focus on communications and problem resolution.
• Proficiency in advanced computer skills

• Caregivers whose duties require them to conduct home or community visits must maintain current BLS certification, have a current driver's license, current auto insurance, an acceptable driving record and reliable transportation.

Preferred Qualifications

• Associate or bachelor's degree.
• Previous experience with medical terminology .
• Excellent verbal and written communications skills.

Physical Requirements

• Ongoing need for employee to see and read information, labels, documents, monitors, identify equipment and supplies, and be able to assess customer needs.
• Frequent interactions with providers, colleagues, customers, patients/clients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately.
• Manual dexterity of hands and fingers to manipulate complex and delicate supplies and equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc.
• Mental stamina and flexibility- ability to handle high stress situations, make quick decisions, and manage multiple tasks simultaneously.
• For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing, and reading signs, traffic signals, and other vehicles.

Location:

Intermountain Health McKay-Dee Hospital

Work City:

Ogden

Work State:

Utah

Scheduled Weekly Hours:

40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$20.07 - $28.59

We care about your well-being - mind, body, and spirit - which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits package here.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

At Intermountain Health, we usethe artificial intelligence ("AI") platform, HiredScore to improve your job application experience.HiredScore helps match your skills and experiences to the best jobs for you. WhileHiredScore assists in reviewing applications, all final decisions are made byIntermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.

All positions subject to close without notice.