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Utilization Management Technician - Vista, CA

UnitedHealth Group

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Job Details

Utilization Management Technician - Vista, CA(Job Number:730982)

Careers at OptumHealth. We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well - being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen.


For over 18 years, North American Medical Management, California, Inc. (NAMM California) has been an innovator in healthcare with a track record for quality, financial stability, extraordinary services and integrated medical management programs.


NAMM California and OptumHealth share a common goal of bringing patients, physicians, hospitals and payers closer together in the mission to increase the quality, efficiency and affordability of care. NAMM California develops and manages provider networks, offering a full range of services to assist physicians and other providers in supporting patient care coordination and their managed care business operations.


UM Technician will work closely with UM team following through with contract changes, referral training with Providers, Office Manager Meetings/Trainings, and involvement with other Process Improvements such as Protocols.


Primary Responsibilities:

  • Verifies eligibility and benefits via the various Health Plans
  • Inputs referrals into the computer and generate hard copies if needed
  • Provides referral and authorization to external providers and / or provide status
  • Input ICD9-10 codes and CPT codes into computer for referrals
  • Provides information required for denial letters to clerical staff for patients whose benefits do not cover the requested services
  • Prepares assigned correspondence and / or reports as directed (complies statistical data)
  • Supports and facilitates teamwork within the department/group setting
  • Maintains good attendance
  • Participates in scheduled department / group meetings

Job Clinical Admin & Processing
Primary Location US-CA-VISTA
Other Location 
Organization NAMM California
Schedule Full-time
Number of Openings 1
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UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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