Position Description

Utilization Management Technician
Location Charleston, SC
Primary Job Function Medical Management
ID** 22361
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Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.

This role is eligible for a $1,500 sign-on bonus


The Utilization Management Tech functions under the direction of the Supervisor to coordinate, generate and track both incoming and outgoing correspondence, faxes and authorizations related to prospective, concurrent and post service review functions. Interacts with facilities, vendors, providers, and other staff to facilitate receipt of information, and /or records for prompt review and response.  Compensation plans for physicians, licensed nurse reviewers, staff, and consultants who conduct medical management do not contain incentives, directly or indirectly, that encourage barriers to care and service in making determinations.

Education/ Experience:

  • High School Diploma or GED required.
  • Minimum 1 year general office and/or customer service experience required.
  • Work experience in healthcare setting required.
  • Experience with Prior Authorization or Medical Coding expereince preferred. 
  • Knowledge of medical terminology required.
  • 1 to 3 years office experience.
  • Proficiency with Microsoft Office Suite (Word, Excel, Power Point). 
  • Access is a plus. 



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