Utilization Management Representative Job at Robert Half in Pearland

We are offering a contract employment opportunity for a Utilization Management Representative in Pearland, Texas. The Utilization Management Representative role is primarily focused on providing office support within the Utilization Management and Population Health Department, with a strong emphasis on data entry, reporting, planning, review, and supervising collection processes.

Responsibilities:

• The UMR position will assist with incoming authorization requests data entry of clinical information pre-certification requests.

• Direct communication with KSC Clinic Representatives as needed.

• Clerical support relative to the Bed Day process.

• Collection reporting clarification and entry of bed day data and pre and post-acute certification requests for specific services.

• 2 –3 years of managed care experience either in a physician office or hospital setting health plan, ACO, or other managed care setting.

• Knowledge of medical terminology, HMO, PPO and referral processes.

• Epic System usage.