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Utilization Management Assistant

Job in Des Moines, Polk County, Iowa, 50319, USA
Listing for: MercyOne
Full Time position
Listed on 2026-03-12
Job specializations:
  • Healthcare
    Healthcare Administration, Healthcare Nursing
Salary/Wage Range or Industry Benchmark: 60000 - 80000 USD Yearly USD 60000.00 80000.00 YEAR
Job Description & How to Apply Below

Position Summary

The Utilization Management Assistant provides administrative and clinical support for utilization review activities, working closely with UM nurses, physicians, and care teams. This role helps ensure timely authorizations, accurate documentation, and coordination of high‑quality, cost‑effective patient care.

Employment Type

Full time

Shift

FT Days (8 hours)

Department

Care Coordination

Key Responsibilities
  • Initiate and process authorizations for admissions and medical services.
  • Review medical records and extract key information to support utilization review.
  • Assist with communication to internal and external providers regarding benefits, approvals, denials, and care processes.
  • Notify external entities of discharges and post‑acute transitions.
  • Support quality and performance improvement initiatives.
  • Gather documentation for service denials and elevate concerns appropriately.
  • Collaborate with Care Management and Population Health teams on process improvements.
Qualifications
  • 1–2 years’ experience as an LPN, Medical Assistant, CNA, or similar healthcare role.
Required
  • MA or CNA certification or LPN license (active, unrestricted).
  • High school diploma or GED (for MA/CNA roles).
  • Experience with utilization management, concurrent review, or discharge coordination preferred.
  • Strong computer skills, including Microsoft Excel, Word, and electronic systems.
  • Excellent communication, organization, and attention to detail.
  • Mandatory Reporter training within 3 months of hire.
Work Environment
  • Frequent walking, standing, typing, phone use, and medical record review.
  • Medium work: lifting up to 50 lbs occasionally.
  • Potential exposure to infectious materials and clinical hazards.
Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person‑centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

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