Utilization Management Operations Trainer - Utilization Management
San Diego, CaliforniaJOB SUMMARY:
Under the supervision of the UM Operations Manager, the UM Operations Trainer's primary job function is to support Utilization Management operations by training non-clinical staff on how to successfully perform any non-clinical tasks. This includes, but is not limited to, initial authorization processing (data entry, eligibility verification, benefits verification, and requesting required supporting documents from submitting provider offices), answering the phone (including all calls regarding authorization processing, claims related phone calls, and any other calls received via the call center lines), and appropriately processing required UM notifications (letters, faxes, etc.). The UM Operations Trainer is responsible for practicing all of the functions they perform training on as part of their standard job function.
MINIMUM QUALIFICATIONS:
H.S. Diploma,GED,or Equivalent
2 Years of Experience
Knowledge of medical terminology, ICD-10 Codes, CPT Codes, HCPC Codes, health plan benefits, or claims required
Computer skills required, specifically Excel, EZ-Cap, Word, Outlook, Internet/Web searching, and Epic
Critical thinking skills
Demonstrated commitment to valuing diversity and contributing to an inclusive working and learning environment
PREFERRED QUALIFICATIONS:
Bachelor's Degree
Experience in the provision of training
The current salary range for this position is $28.09 to $38.62
Rady Children’s Hospital is committed to compensation that is externally competitive and internally equitable. We demonstrate this commitment by conducting regular market reviews to remain competitive with organizations of similar size in the nonprofit, healthcare sector. The range listed above does not represent the full salary range for the position but is the expected hiring range for qualified candidates. Compensation decisions consider a variety of factors including experience, education, licensure, unique skillsets, organizational need, and internal equity. This posting will remain open from the “date posted” until the hiring manager has determined there is a sufficient applicant pool or until the position is filled.
