Utilization Management Technician (Temp to Hire)

Remote

Responsibilities

Prepare prior authorization requests received by validating prescriber and member information, level of review, and appropriate clinical guidelines
Review and analyze pharmacy claims data for proactive outreach and intervention.
Identify, document, and escalate provider concerns to the appropriate internal team including various members of the Prior Authorization Team
Ensure customer satisfaction, extraordinary customer care, and quality resolution with genuine compassion in a fast paced, startup environment Required

Judi® , the industry’s leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.
experience in a PBM, health plan, or in another clinical pharmacy setting •
Experience handling prior authorization requests/understanding of prior authorization requirements required
National Certified Pharmacy Technician (CPhT) license, required
High school diploma or the equivalent; Associate’s or bachelor’s degree is preferred
Ability to work independently with minimal supervision, stay productive in a remote, high-volume, metric driven call center environment
Ability to multi-task and collaborate in a team with shifting priorities

This range represents the low and high end of the anticipated base salary range for the NY - based position.
The actual base salary will depend on several factors such as: experience, knowledge, and skills, and if the location of the job changes.
This range represents the low and high end of the anticipated base salary range. The actual base salary will depend on several factors such as: experience, knowledge, skills, and location of the job.