Supervisor, Utilization Management Technician
New
J
Judi HealthHealth Technology
Remote (For Non-Local) or Hybrid (Local to NYC area)Full-TimeManager
Salary70,000 - 80,000 USD per year
Apply NowOpens the employer's application page
Job Details
- Experience
- 1 year of Medicare experience
- Required Skills
- Microsoft ExcelPowerPointHIPAA
Requirements
- At least 1 year of Medicare experience, including working knowledge of policies and guidelines
- Minimum 1 year of Medicare Prior Authorization and/or Medicare appeals experience
- Demonstrated ability to communicate effectively and manage team priorities
- Strong organizational and problem-solving skills
- Active, unrestricted, National Certified Pharmacy Technician (CPhT) license required
- Proficient in Microsoft Office Suite with emphasis on Microsoft Excel and PowerPoint
- Strong clinical background required
- Excellent communication, writing, and organizational skills
- Ability to multi-task and collaborate in a team with shifting priorities
Responsibilities
- Oversee a group of prior authorization technicians and expanded responsibility for select administrative PA functions.
- Work in conjunction with the pharmacy technician manager in analyzing available data and provide prior authorization staffing, workflow and system enhancement recommendations.
- Support on-going training and coaching of utilization management pharmacy technicians.
- Participate in the goal setting process and regularly review performance of direct reports.
- Investigate/resolve escalated issues or problems from clients and providers.
- Review pharmacy claims data for proactive outreach and intervention.
- Maintain quality and productivity standards for all cases triaged while minimizing compliance risk.
- Prepare prior authorization requests received by validating prescriber and member information, level of review, and appropriate clinical guidelines.
View Full Description & ApplyYou'll be redirected to the employer's site
