What are the responsibilities and job description for the Utilization Review Manager position at EBPA?
Description:
The Intake Manager will be responsible for leading the Utilization team's Intake Analysts and nurses with administrative responsibilities related to various stages of the Company’s standard medical review practices. In short, this team reviews medical records and builds cases to further examine how our group health plans are required to pay or adjudicate certain medical claims.
Primary Responsibilities:
- Provides the other Intake Analysts with a direct supervisor who can closely assign and monitor work, oversee projects, provide guidance and development, identify individual and team goals, offer suggestions, along with the 2 on-staff nurses
- Performs data entry of authorization information (per policy/procedure) into web-based system as received through telephone calls, voice mail messages and emails
- Gathers and organizes clinical information for review
- Communicates authorization request status to the providers as per policy and procedure
- Writes coverage determination letters
- Works with computer/electronic medical records on a daily basis
- Performs other duties as assigned
Required Qualifications:
- 2-4 years of prior Utilization Review and medical case management setting; clinical experience not required but encouraged
- Demonstrate a proficiency in computer skills – Windows, Word, Excel, Outlook, clinical platforms, internet searches
- Knowledge of ICD 10 codes, CPT codes and medical terminology
- Detail oriented, self-sufficient and decisive
- Excellent organizational and communication skills
- Ability to be flexible and work in a fast-paced office environment
- Managerial experience
Salary : $57,900 - $73,300
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