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St. Joseph Health / Covenant Health Senior Utilization Management Assistant in Anaheim, California

St. Joseph Heritage is looking for Sr. UM Assistant to join our growing Utilization Management Department and value driven organization.

Location: Anaheim

Hours: 8 AM to 5 PM

Shift: Monday through Friday

Job Summary:

Under minimal supervision, assists providers and other health care professionals providing resources for the physician offices to assist in the processing of patient referral requests. . This position plays an important role in educating provider office staff in the referral and medical review process including the importance of timeframes and notification requirements to meet health plan, state, and federal regulations; what is required in completing the referral; providing CPT information; provider selection options and any other questions that the provider offices may have. . This position works in a team environment under the supervision of the Supervisor/Manager and includes organizing work assignments and daily activities to ensure timely completion of the referral and tracking process. This position will oversee the implementation and completion of required reports for the UM referral process.

Minimum Position Qualifications:

Education: High School Diploma or equivalent required.

Experience: Requires one (1) year UM experience in a managed care setting.

Computer Skills:

• Advanced MS Word, Excel, and Windows experience required.

• Advanced IDX and Touchworks Systems


• Medical Terminology and Coding background required.

• Valid California Driver’s License in order to travel to other SJHH locations.

• Ability to type 45 WPM, accurately.

Preferred Position Qualifications:


• Four (4) plus years of experience in a managed cares setting strongly desired.

Licensure/Certification: Medical Assistant Diploma from a State recognized School

Other: Bilingual English/Spanish communications skills preferred.

Environmental Conditions: May include exposure to potentially hazardous material, infectious agents, contact with patients, public and staff.

Physical Requirements: Sitting for long periods of time, bending, reaching, stooping, kneeling, pushing/pulling, lifting/carrying up to 24 lbs., and grasping.

St. Joseph Heritage Healthcare (SJHH) is one of California's most respected medical groups. With over 3,000 employees and 75 locations throughout California, including, Northern California, Orange County, High Desert and Los Angeles County, SJHH has been continually recognized as a leader in quality, customer service and information technology. This kind of success is the result of team work, a commitment to excellence and a strong adherence to the organization's mission, vision and values.St. Joseph Heritage Healthcare (SJHH) provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, St. Joseph Heritage Healthcare (SJHH) complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Company: Heritage Healthcare

Category: Health Care