Lucent Health Solutions LLC is hiring: Utilization Review Intake Support Special

About Lucent Health

Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers.

Company Culture

We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health.

Honest

• Transparent Communication: be open and clear in all interactions without withholding crucial information
• Integrity: ensure accuracy in reporting, work outputs and any tasks assigned
• Truthfulness: provide honest feedback and report any issues or challenges as they arise
• Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior

Ethical

• Fair Decision Making: ensure all actions and decisions respect company policies and values
• Accountability: own up to mistakes and take responsibility for rectifying them
• Respect: treat colleagues, clients and partners with fairness and dignity
• Confidentiality: safeguard sensitive information and avoid conflicts of interest

Hardworking

• Consistency: meet or exceed deadlines, maintaining high productivity levels
• Proactiveness: take initiative to tackle challenges without waiting to be asked
• Willingness: voluntarily offer to assist in additional projects or tasks when needed
• Adaptability: work efficiently under pressure or in changing environments

Summary

The UR Support Specialist is a key part of the Utilization Review team based in Nashville, Tennessee. The UR Support Specialist, as a part of the multidisciplinary care team, is responsible for supporting the Utilization Review nurses as they review and authorize medical treatment for patients.

Job Responsibilities

• The UR Specialist supports the multidisciplinary care team by ensuring seamless delivery of the Narus program for individuals and their families by providing the following services:
• Providing an excellent member experience through direct communication through inbound and outbound calls and secure messages.
• Screen incoming calls with registered nurse supervision.
• Perform appropriate screening and escalation of calls to the clinical team.
• Calls external facilities and providers as directed by UR supervisor
• Takes inbound calls to coordinate patient authorizations
• Assists work from home-based team with faxing, documentation, and telephonic or virtual support of care management priorities.
• Participate in monthly team meetings.

Qualifications & Professional License Requirements

• At least three (3) years of related experience or equivalent, preferably in a physician office or clinical call center.
• High school diploma required.
• Patient, compassionate, and professional personality with a strong service orientation.
• Demonstrated problem solving skills
• Proficient in Microsoft Office programs, EMR/Care Management platforms, and keyboarding.
• Demonstrated knowledge of legal and ethical issues related to confidentiality, including HIPAA and state specific privacy laws.
• Commitment to excellence and high standards.
• Excellent time management, flexibility, and organizational skills with the ability to work independently.
• Critical thinking and good judgement to quickly determine and prioritize issues
• Good communication, teamwork, and interpersonal skills with the ability to work with all levels of management.
• Prior telephonic patient engagement or care coordination experience preferred.

Equal Employment Opportunity Policy Statement

Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.