Utilization Management CNA
Skills
- Strong interpersonal and communication skills
- Customer service with ability to handle sensitive information
- Detail-oriented with accuracy in reviewing pre-certifications and plans
Responsibilities
- Answer first level calls in Utilization Review for member participants
- Evaluate certification requests per group-specific requirements
- Triage calls to Utilization Review Nurses when appropriate
- Review medical records and coordinate with healthcare providers
- Ensure patients receive cost-effective care according to clinical guidelines and insurance
Education
- Certified Nursing Assistant (CNA), Licensed Practical Nurse (LPN), or Medical Assistant certification
- Background in patient health support or care
Benefits
- Medical, Dental, Vision Insurance starting day 1
- Flexible Spending Account (FSA) or Health Savings Account (HSA)
- 401(k) with company match
- Profit-Sharing/Defined Contribution after 1 year
- Paid Time Off and Paid Holidays
- Company-paid Short Term and Long Term Disability
- Maternity Leave/Parental Leave
- Subsidized Parking
- Company-paid Term Life/Accidental Death Insurance
Average salary estimate
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