About the position Responsibilities • Intake information regarding the authorization of services for members. • Communicate with case managers, PCPs, and members to promote quality service delivery. • Monitor members' utilization patterns to identify high-risk cases and under/over use of services. • Clarify benefits for providers. Requirements • High school diploma or equivalent. • Two years' experience in a medical practice office, urgent care, hospital, skilled nursing facility, or other healthcare setting, along with completion of a medical-related training program (e.g., Medical Assistant, EMT, Nursing Assistant). • OR three years' experience in a medical practice office, urgent care, hospital, skilled nursing facility, or other healthcare setting. Nice-to-haves • One year of Managed Care Utilization review experience. • Experience and knowledge of the preauthorization process for medical services. • Physician office experience. • Experience and knowledge of Medicare, HMO, PPO, TPA, PHO, and Managed Care functions. Apply tot his job