Utilization Management Assistant

Where You’ll Work

Baylor St. Luke’s Medical Center is an 881-bed quaternary care academic medical center that is a joint venture between Baylor College of Medicine and CHI St. Luke’s Health. Located in the Texas Medical Center, the hospital is the home of the Texas Heart® Institute, a cardiovascular research and education institution founded in 1962 by Denton A. Cooley, MD. The hospital was the first facility in Texas and the Southwest designated a Magnet® hospital for Nursing Excellence by the American Nurses Credentialing Center, receiving the award five consecutive times. Baylor St. Luke’s also has three community emergency centers offering adult and pediatric care for the Greater Houston area.

Job Summary and Responsibilities

As our Utilization Management (UM) Assistant, you will provide essential administrative and clerical support to the UM team, playing a crucial role in maintaining efficient and organized operations.

Every day you will manage documentation, process incoming requests, facilitate communication between team members and external parties, and assist with data entry and record-keeping to ensure smooth UM workflows.

To be successful in this role you will possess excellent organizational skills, a keen eye for detail, strong communication abilities, and a proactive approach to supporting the daily functions of the Utilization Management department.

• Receives, sends and documents payer requests for clinical documentation
• Receives and documents payer authorization and communications including but not limited to concurrent denials
• Coordination of peer to peer conversations 
• Reviews surgery schedule 
• Under direction of RN submit request for and follows up on administrative days authorization

Job Requirements

• High School Diploma or GED required 
• 1 year of experience in a hospital, physician's office or medical group performing duties related to admitting, business office, payer communications or managed care or an equivalent combination of education and experience