Utilization Management Assistant

Description Utilization Management Assistant (279237) Schedule: FTE 1.0, Monday-Friday 08:00AM - 4:30PM PST (8HR SHIFT), Day The primary responsibility of the position is to maintain standard compliance and performance related utilization management data. Process of daily, weekly and monthly UM reports. Establishes and maintains efficient filing system in paper and electronic. Maintains Health Plan audit tools including distribution and collection of data and documentation. Assists in data collection for all Health Plan audits and in necessary compilation of data for NCQA, DMHC and CMS focused audits and unplanned audits of the delegated Medical Group as downstream providers. Performs other duties as assigned by immediate Supervisor UM Compliance Manager and in support of compliance timelines. Under the supervision of Administrative Director of Health Services. The position requires strong analytical and utilization modeling skills employing data from the Referral, Beddays and claims data bases published by Decision Support. Requires strong interpersonal, professional communication skills. Answers and screens phones. Schedules and coordinates all Health Plan audits attended by Administrative Director of Health Services, Sr Contract Manager, Case Managers and UM Directors, Managers and Supervisors. Provides vacation coverage for Executive Administrative Assistant duties as assigned. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Regional Medical Center Everett and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence Regional Medical Center Everett received the HealthGrades Distinguished Hospital Award for Clinical Excellence four years in a row. Required Qualification: Associate's Degree in Health care, business or related field preferred Or equivalent educ/experience Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons. Apply Today! Applicants that meet qualifications will receive a text with some additional questions from our Modern Hire system. About Providence At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Check out our benefits page for more information about our Benefits and Rewards. About the Team Providence has been serving the Pacific Northwest since 1856 when Mother Joseph and four other Sisters of Providence arrived in Vancouver, Washington Territory. Today, Providence is the largest health care provider in Washington located in communities large and small across the state. In western Washington, Providence provides care throughout the greater Puget Sound from Snohomish County to Lewis County. Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care. Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Requsition ID: 279237 Company: Providence Jobs Job Category: Health Information Management Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Day Career Track: Admin Support Department: 3002 UTIL REVIEW WA PRMCE B1 COLBY Address: WA Everett 1321 Colby Ave Work Location: Everett Medical Ctr Colby-Everett Pay Range: $20.64 - $31.52 The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Check out our benefits page for more information about our Benefits and Rewards.