Utilization Management Cover Letter

Utilization Management Cover Letter

4.9
165 votes for Utilization Management

15 Utilization Management cover letter templates

What to include in a Cover Letter
1
Company Address
2
Salutation
3
Compelling Details
4
Respectful Closing

How to Write the Utilization Management Cover Letter

5741 Cummings Creek
New Prestontown, IA 36189-6571
Dear Landry Borer,

In response to your job posting for utilization management, I am including this letter and my resume for your review.

In my previous role, I was responsible for leadership and directs teams in achievement of ACO, managed care and direct contracting shared savings initiatives.

My experience is an excellent fit for the list of requirements in this job:

  • Knowledge of MCG , InterQual, Medicaid and/or Medicare/CMS criteria
  • Previous managed care experience (Prior Authorization, Utilization Management)
  • Understanding of DME Prior Authorization
  • Experience working with ICD 10/CPT coding
  • Active, unrestricted RN license, compact multistate license, or in the state of VA
  • Current Florida RN licensure (active/clear)
  • Knowledge of the authorization process and procedures
  • Demonstrated experience managing multiple call lines and successfully triaging calls

I really appreciate you taking the time to review my application for the position of utilization management.

Sincerely,

Hayden Nolan

Responsibilities for Utilization Management Cover Letter

Utilization management responsible for clinical information to managed care organizations that recognizes their review style, criteria, performance standards, and needs.

Experience writing and implementing program level policy and procedures
Experience in a health care environment and familiarity with coding and/or medical terminology preferred
Confirm that a post inpatient discharge plan is in place and monitor the progress of that plan
Gather clinical information to assess and expedite care needs following company policies
Maintain appropriate legal documentation within operating platform
Consult with the Medical Director as needed to troubleshoot difficult or complex cases and if medical necessity criteria is not met
Participate in telephonic (WebEx) staff meetings and on-line learning
Active, unrestricted RN licensure in the state of VA

Utilization Management Examples

Example #1

Example of Utilization Management Cover Letter

884 Deckow Court
Dudleyburgh, NV 73781
Dear Onyx Homenick,

Please consider me for the utilization management opportunity. I am including my resume that lists my qualifications and experience.

In my previous role, I was responsible for denial reports on a monthly, quarterly, and requested basis to the Care Management Department, Patient Financial Services, Managed Care Contracting, Revenue Cycle, and hospital leadership including the CEO.

Please consider my experience and qualifications for this position:

  • Knowledge of medical terminology, ICD-10
  • Work experience in healthcare setting with familiarity of Home and Community Based (HCBS) waivers, experience in Utilization management and familiarity with Medicaid preferred
  • Strongly prefer medical assistant, home health aide, nursing assistant, or other similar health care para-professional training or certification
  • Medical Terminology highly recommended
  • Currently enrolled in a health care related field of study preferred
  • Demonstrated knowledge of medical terminology, ICD-10
  • Knowledge of insurances and managed care
  • Demonstrates willingness to assist others

I really appreciate you taking the time to review my application for the position of utilization management.

Sincerely,

Dylan Reichert

Example #2

Example of Utilization Management Cover Letter

40003 Ankunding Summit
Feilburgh, AR 13042-7688
Dear Royal Boehm,

Please consider me for the utilization management opportunity. I am including my resume that lists my qualifications and experience.

Previously, I was responsible for input to managed care department on utilization management activities and communicates to staff.

I reviewed the requirements of the job opening and I believe my candidacy is an excellent fit for this position. Some of the key requirements that I have extensive experience with include:

  • Foster excellent working relationships with all stakeholders
  • Experience working in a Case/Care Management department
  • Experience working with individuals with mental health or substance use disorders
  • Independently or in a team, should be able to identify the root issues and formulate potential solutions
  • Prefer someone in MST Zone
  • Knowledge of regulatory and accrediting standards relating to medical management and managed care
  • Knowledge of medical terminology and claims processing
  • Creative problem - solving and communication skills

Thank you in advance for reviewing my candidacy for this position.

Sincerely,

Stevie Romaguera

Example #3

Example of Utilization Management Cover Letter

485 Coleman Throughway
South Jaimeeshire, VA 23091
Dear Emery Nolan,

I would like to submit my application for the utilization management opening. Please accept this letter and the attached resume.

Previously, I was responsible for direction and oversight to ensure effective management of inpatient care, discharge planning, and prior authorizations for medical or behavioral health.

I reviewed the requirements of the job opening and I believe my candidacy is an excellent fit for this position. Some of the key requirements that I have extensive experience with include:

  • Complete pre-certification for HLOC admissions
  • Complete retro-reviews and retro-authorizations for inpatient and/or emergency services
  • Makes self-available to daytime and afterhours clinical team for questions or guidance on UM activities
  • Complete quarterly chart audits of Utilization Management Staff
  • Monitor consistency among UM staff in application of level of care criteria
  • Assist with referral and triage process and review all emergent cases with Director of UM and Physician Advisor
  • Complete annual performance review of UM staff
  • Monitor UM caseloads/workload and performance

Thank you in advance for taking the time to read my cover letter and to review my resume.

Sincerely,

Jordan Kihn

Example #4

Example of Utilization Management Cover Letter

85364 Koelpin Streets
South Hueybury, NC 00790-6633
Dear Campbell Kshlerin,

Please consider me for the utilization management opportunity. I am including my resume that lists my qualifications and experience.

Previously, I was responsible for consultation to health care teams by analyzing ethical/care issues and appropriate theoretical principles providing guidance as appropriate.

Please consider my qualifications and experience:

  • Update and educate staff of any changes to policies and procedures
  • Review monthly UM performance metrics and collaborate with UM Director, Manager and Supervisor for data analysis and quality and performance improvement strategies
  • Coordinate and help facilitate monthly staff meeting with UM Manager/Supervisor
  • Coordinate with UM Manager/Supervisor and help facilitate weekly case conferences with Medical Director, Health Plans and Case Management
  • Hiring and termination of department staff
  • Training new staff regarding utilization management process, workflow and policies and procedures
  • Develop relationship and function as a back-up liaison with payers, providers and facilities
  • Knowledge of medical necessity and treatment protocols for psychiatric and chemical dependency treatment

Thank you for your time and consideration.

Sincerely,

Phoenix Lebsack

Example #5

Example of Utilization Management Cover Letter

36136 Noble Keys
Legroschester, ND 49475
Dear Landry Boyle,

I am excited to be applying for the position of utilization management. Please accept this letter and the attached resume as my interest in this position.

Previously, I was responsible for professional and administrative leadership for social workers and care coordinators responsible for providing complex care coordination services to high risk patients with diverse insurances.

Please consider my experience and qualifications for this position:

  • Able to work effectively and achieve results in a real time, fast paced environment
  • Analytical skills with strong organization skills
  • Job requires sitting for prolonged periods
  • Working experience with MCG or Integral evidence based guidelines highly preferred
  • Experience with computer skills with Windows information systems/computer workstation preferred
  • Experience with telecommunication equipment and office equipment/supplies preferred
  • Medical assistant, home health aide, nursing assistant, or other similar health care para-professional training or certification
  • Registered Licensed clinical professional counselor (LCPC), Licensed Professional Counselor (LPC), or Licensed Clinical Social Worker (LCWS)

Thank you for your time and consideration.

Sincerely,

Landry Wiza

Resume Builder

Create a Resume in Minutes with Professional Resume Templates