Utilization Management Clerk
Location: Orange, California US
Job Number: 2461
Position Title: Utilization Management Clerk
Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time.
By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community.
The Utilization Management (UM) Clerk will assist in the clerical support to the UM department staff (i.e. incoming/outgoing mail, data entry, filing, etc.)
(May include but are not limited to)
- Responsible for processing incoming and outgoing mail for the UM Department.
- Maintains inventory of office supplies at a level necessary for proper functioning of the department.
- Performs clerical duties deemed necessary to ensure smooth functioning of the department.
- Performs data entry as requested.
- Assist Inpatient team by entering Face Sheets and faxes.
- Data integrity testing for new projects or project enhancement
- Ensures delegated IPA/MGs provide CCHP with discharge dates, authorized days and discharge disposition on members assigned to delegated IPA/MG by faxing requests for information, tracking receipt of information and forwards information to Inpatient Team.
- Call hospitals to obtain billing charges and maintain billing log.
- Meets specific deadlines (responds to various workload by assigning task priorities according to department policies, standards, and needs).
- Maintain Department miscellaneous filing in an organized fashion as well as create files as needed.
- Recognizes work-related problems and contributes to solutions.
- Maintains confidentiality of information between and among health care professionals.
- Other duties as assigned by UM Management.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Minimum Experience:
- Minimum of one-year in clerical support.
- High school diploma or general education degree (GED)
- At least six months related experience and/or training; or equivalent combination of education and experience.
- Language Skills: Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Ability to write routine reports and correspondence.
b. Mathematical Skills: Ability to add and subtract two digit numbers and to multiply and divide with 10’s and 100’s. Ability to perform these operations using units of American money and weight measurement, volume, and distance.
c. Typing speed 45 wpm and proficient use of 10-key calculator.
- Computer Skills: Microsoft Office. Knowledge of computer programs and applications required.
- Reasoning Skills: Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions.
i. Excellent communication skills, oral and written.
- Work Environment
a. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
i. The noise level in the work environment is usually moderate.
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear.
2. The employee is frequently required to walk; stand; reach with hands and arms.
3. The employee is occasionally required to climb or balance and stoop, kneel, crouch, or crawl.
4. The employee must occasionally lift and/or move up to 20 pounds.
5. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.
If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact email@example.com.
Location City: Orange
Location State: California
Community / Marketing Title: Utilization Management Clerk
Who is Alignment Healthcare?
- Socially responsible
- Technologically enabled
- Concierge care
- Servant leadership
We are dedicated to transforming the complex and confusing process of medical treatment in the United States so that every link in the health care continuum becomes more efficient, productive, and effective. We built a team of people who want to make a difference. Come join the team that is changing health care one person at a time.
We believe that great work comes from people who are inspired to be their best. We invite you to explore our wide variety of roles based on your unique experience.