Utilization Management Assistant

GENERAL SUMMARY:

Under general supervision, the Utilization Management Assistant supports the administrative requirements for Utilization Management and works collaboratively with Utilization Management/Concurrent Review Nurse, physicians, staff and other health care professionals. Interacts with internal and external providers to review and monitor members’ utilization of health care services with the goal of maintaining high quality cost effective care. Works collaboratively with staff to obtain information from clinical reviews and medical records in order to provide the appropriate communication for authorization of medical services and procedures. Collaborates on system-wide quality improvement/performance improvement initiatives

GENERAL SUMMARY:

Performs clerical work and coordinates communications within the assigned nursing unit. Facilitates communication between the nursing unit and other hospital departments.

ESSENTIAL FUNCTIONS:

• Performs clerical duties for the nursing unit by maintaining charts; answering multi-line phones; greeting and assisting customers in a friendly and timely manner; and sorting and distributing mail.
• Utilizes computer applications (Electronic Health Records, etc.) and communication technologies (Teletracking, Vocera, Hillrohm System, etc.) effectively.
• Communicates patient information or department needs such as dietary, environmental services, and all Information Technology issues.
• Maintains a safe, neat, and organized work environment by ordering and stocking supplies, forms, and equipment as necessary. Identifies and reports problems with supplies or equipment; enters repair requests; and conducts environmental rounding.
• Prepares documents and records in compliance with regulatory requirements.
• Demonstrates work practices consistent with safety, security, and infection control policies, including adhering to the Safe Medication Handling protocol for both delivery and removal of medications.

MARGINAL FUNCTIONS:

• Conducts auditing of records, data, and transactions per unit management team request.
• Maintains meeting room schedule

GENERAL SUMMARY:

Performs clerical work and coordinates communications within the assigned nursing unit. Facilitates communication between the nursing unit and other hospital departments.

CORPORATE PHILOSOPHY STATEMENT:

It is the obligation of each employee of Mercy Medical Center to abide by and promote the mission and core values of the Spirit of Mercy.

CORPORATE POLICY STATEMENT:

It is the obligation of each employee of Mercy Medical Center to comply with Mercy’s mission, values, standards of conduct, policies, procedures, and related practices (e.g., Dress Code, Time and Attendance, and other policies).

HIPAA SECURITY COMPLIANCE:

Security Access: High “Incumbent has access to restricted or confidential patient information and must comply with the terms of the Mercy Medical Center Security Policies as it applies to their job role.”

ESSENTIAL FUNCTIONS:

• Performs clerical duties for the nursing unit by maintaining charts; answering multi-line phones; greeting and assisting customers in a friendly and timely manner; and sorting and distributing mail.
• Utilizes computer applications (Electronic Health Records, etc.) and communication technologies (Teletracking, Vocera, Hillrohm System, etc.) effectively.
• Communicates patient information or department needs such as dietary, environmental services, and all Information Technology issues.
• Maintains a safe, neat, and organized work environment by ordering and stocking supplies, forms, and equipment as necessary. Identifies and reports problems with supplies or equipment; enters repair requests; and conducts environmental rounding.
• Prepares documents and records in compliance with regulatory requirements.
• Demonstrates work practices consistent with safety, security, and infection control policies, including adhering to the Safe Medication Handling protocol for both delivery and removal of medications.

MINIMUM KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED:

• Must be 16 years of age or older

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.