Utilization Management Assistant

Utilization Management Assistant

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites, and 137 hospital-based locations, in addition to its home-based services and virtual care offerings.

The Utilization Management Assistant plays a crucial supporting role within the Utilization Management department, primarily responsible for facilitating the UM review process, ensuring timely and accurate submission of clinical documentation, and assisting in the coordination of care. This position performs essential administrative, clerical, and communication tasks to support the Utilization Review Nurses and Case Managers, ensuring compliance with regulatory requirements and payer guidelines. The UM Assistant helps to ensure appropriate resource utilization while maintaining high standards of patient care.

• Initiate outbound calls and faxes to insurance companies and other payers to request authorizations for admissions, continued stays, discharges, and other services.
• Monitor and track authorization requests, follow up with payers to ensure timely responses, and document communication accurately.
• Retrieve and compile patient medical records, clinical notes, physician orders, and diagnostic results from electronic health records (EHR) or other systems.
• Organize and prepare clinical information packets for submission to payers for concurrent, retrospective, and pre-admission reviews.
• Manage incoming and outgoing faxes, emails, and phone calls related to UM activities.
• Schedule and coordinate meetings for the UM team.
• Prepare and distribute reports, presentations, and other departmental documents as needed.
• Maintain organized filing systems (electronic and / or physical) for UM documentation.

High School Diploma or GED required. Associate's degree in a healthcare-related field, Medical Office Administration, or Business Administration preferred.

CHI St. Vincent, a regional health network serving Arkansas, is part of CommonSpirit Health. We have served Arkansas since 1888 with a history of many firsts. Together with more than 4500 coworkers, 1000 medical staff, and 500 volunteers we consistently receive praise for care advancements. CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health in 2019. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community. CHI St. Vincent provides you with the same level of care you provide to others. We care about our team member well-being and offer benefits that complement and support your work / life balance.

Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit https : / / www.commonspirit.careers / benefits .

Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.