Job Summary

A software development company is in need of a Remote Utilization Payer Management Specialist.

Core Responsibilities Include:

• Researching and understanding utilization management workflows
• Taking complicated information and making it simple and easy to understand
• Taking complex directions and distill them into clear step-by-step instructions

Position Requirements Include:

• 3+ years experience within utilization management from health plans/payers
• Prior experience managing inbound authorization requests
• Understands how requirements are applied to Approve/Deny/P2P
• Commercial experience and Medicare/Medicaid including understanding of NCD/LCD
• Understanding of reporting and productivity numbers which are important for payer staff
• Ability to take on meaningful responsibility, individual initiative and thrive with limited supervision