UM Analyst II (Medication Analyst)

Company: AllCare Health
Location: Grants Pass
Posted on: November 22, 2021

Job Description:

AllCare offers competitive wages, an excellent benefit package that includes a 401k retirement, wellness program, and telecommute and flexible work schedule programs. This position is eligible for a sign-on bonus.Since 2016, AllCare Health has been a Certified B Corp--. As a Certified B Corp--, AllCare Health considers its impact on society and the environment during the business decision-making process, and has long recognized the real value in social, economic, and environmental concerns of its stakeholders, including its employees, customers, and community members.Grants Pass is located in Southern Oregon on the Rogue River and is surrounded by mountains and breathtaking views. The community is ideal for families and outdoor enthusiasts, with a temperate climate and easy access to outdoor recreation, wineries, outdoor concerts, the Ashland Shakespeare Festival, and much more.AllCare Health requires all employees to be vaccinated against the COVID-19 virus unless there is a qualifying medical and/or religious exemption. Please contact the Human Resources department if you would like to request an accommodation.COVID-19 considerations:AllCare Health is following all safety guidelines and directives from OSHA, the CDC, OHA, and our local public health department.Pay and Benefits:Benefits: 401(k), 401(k) matching, Dental insurance, Disability insurance, Employee assistance program, Employee discount, Flexible spending account, Health insurance, Life insurance, Paid time off, Retirement plan, Tuition reimbursement, Vision insuranceSupplemental Pay: Bonus paySummaryThis position is responsible for processing and conducting the initial review of referrals and prior authorizations according to applicable government and/or health plan policies by performing the following duties.Essential Job Duties

• Intake prior authorization requests and verify member eligibility and benefits
  • Request supporting documentation from Providers
    • Make service determinations based on plan policies
      • Provide oral or written notification to members
        • Monitors service determinations to ensure that they are processed in compliance with government regulationsEducation & ExperienceHigh school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience. Knowledge of or familiarity with ICD and/or CPT/HCPC coding is required.

Keywords: AllCare Health, Medford , UM Analyst II (Medication Analyst), Professions , Grants Pass, Oregon