Utilization Management CNA

The role

The Utilization Management Assistant answers first level calls in Utilization Review for Health & Wellness participants. They evaluate certification requests, triage calls to nurses, review medical records, and coordinate with healthcare providers.

What you will do

• Answer first level calls in Utilization Review
• Evaluate certification requests by reviewing group specific requirements
• Triage calls to determine if a Utilization Review Nurse is needed
• Review medical records
• Coordinate with healthcare providers
• Ensure patients receive appropriate, cost-effective care in accordance with clinical guidelines and insurance requirements

Required qualifications

• Background in patient health support or care
• 1+ years of experience within this field

Nice to have

• CNA, LPN, or Medical Assistant
• Strong interpersonal skills
• Friendly demeanor and understanding
• Accuracy and attention to detail

Benefits

• Medical, Dental, Vision Insurance
• Flex Spending or HSA
• 401(k) with company match
• Profit-Sharing/Defined Contribution (1-year waiting period)
• PTO/Paid Holidays
• Company-paid ST and LT Disability
• Maternity Leave/Parental Leave
• Subsidized Parking
• Company-paid Term Life/Accidental Death Insurance

About the company

Cottingham & Butler aims to hire, train, and grow the best professionals in the industry. Their culture is guided by the theme of better every day.