Utilization Management CNA

We are seeking a dedicated Utilization Management CNA to join our healthcare team. This role is ideal for CNAs, Medical Assistants, LPNs, or individuals with a background in patient health support who are looking to make a meaningful impact behind the scenes. If you are looking to get into a professional office setting with daytime office hours and weekends/holidays off, this is the role for you! The Utilization Management Assistant answers first level calls in Utilization Review for member participants. You will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You will be responsible for reviewing medical records, coordinating with healthcare providers, and ensuring that patients receive appropriate, cost-effective care in accordance with clinical guidelines and insurance requirements.