**Req ID:** 336708 NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now. We are currently seeking a TEMP BPO Senior Associate to join our team in Decatur, Illinois (US-IL), United States (US). **Utilization Management Coordinator** As part of our Mission to make Healthcare more accessible and affordable for our clients through innovation solutions and expert consultation, we value the inherent qualities that are foremost in our Mission, Vision, Values- Compassion, Humility and Impact, which allow us all to create authentic relationships with our team and our clients. **Position Summary:** The Utilization Management Coordinator reports to the Director of Claims. This position is responsible for coordinating the appeal activities and UM process which includes initiating Case Management, requesting Pre-certification, submitting Medical Reviews, and Independent Dispute Resolution. The successful candidate(s) will bring the utmost level of service, professionalism, and commitment to this position. **Essential Duties and Responsibilities:** + Gather, analyze, and report information regarding member and provider appeals. + Prepare and respond to written inquiries from employer, members, and providers in accordance with Department of Labor guidelines and applicable summary plan document language. + Maintain files and logs for all appeals. + Interface with various managed care organizations, UM, and cost containment Vendors to coordinate reviews for medical necessity including pre-determinations and retrospective reviews. + Review submissions by the Claims Department to determine appropriateness of services through established UM guidelines, Trilogy, summary plan document review, etc. + Actively participate in meetings including presentation of reports, statistics, etc. + Perform other related duties and participate in special projects as assigned. **Knowledge, Skills and Abilities:** + Strong administrative/technical skills; Comfortable working on a PC using Microsoft Office, Microsoft Teams, and telephones efficiently. + Excellent communication skills (spoken and written); comfortable talking on the phone for extended periods of time and replying to emails in a timely manner. + Trustworthy and accountable behavior, capable of viewing and maintaining confidential personal information daily. + Willingness to routinely, reliably come to work on schedule and adjust shift/scheduling based on the needs of the organization (including occasional paid overtime) + Education: High School Diploma or General Education Development (GED) equivalent. **General Expectations:** + Always present a positive image of Consociate. + Provide and promote the delivery of services with a prevailing attitude of respect and recognition of the personal worth and dignity of every individual. + Communicate in a clear and concise manner, while also demonstrating receptivity through active listening. + Identify and perform work that has not been specifically assigned, as needed. + Adhere to established safety standards and utilizes proper techniques to avoid work-related injuries. + Continuously seek opportunities for improvement and suggest ways in which procedures/systems may be modified to accomplish tasks/goal efficiently and effectively. + Demonstrate a teamwork philosophy by working cooperatively with others inside and outside the Client Services Division. + Attend required in-service and staff meetings. + Preserve the confidentiality of all business-sensitive information, including but not limited to that of insured groups and individuals, employees, and applicants. **Physical and Mental Abilities:** + Ability to perform sedentary work for extended periods of time. + Ability to utilize personal computer (manual dexterity is required to operate a keyboard), telephone system, and communicate with a variety of team members. + Ability to concentrate, meet deadlines, work on several projects during the same period, and adapt to interruptions. **Working Conditions:** + Work is performed in a normal office environment or offsite. **About NTT DATA** NTT DATA is a $30 billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize and transform for long term success. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure and connectivity. We are one of the leading providers of digital and AI infrastructure in the world. NTT DATA is a part of NTT Group, which invests over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. Visit us at us.nttdata.com (http://us.nttdata.com/en) Whenever possible, we hire locally to NTT DATA offices or client sites. This ensures we can provide timely and effective support tailored to each client’s needs. While many positions offer remote or hybrid work options, these arrangements are subject to change based on client requirements. For employees near an NTT DATA office or client site, in-office attendance may be required for meetings or events, depending on business needs. At NTT DATA, we are committed to staying flexible and meeting the evolving needs of both our clients and employees. NTT DATA recruiters will never ask for payment or banking information and will only use @nttdata.com and @talent.nttdataservices.com email addresses. If you are requested to provide payment or disclose banking information, please submit a contact us form, https://us.nttdata.com/en/contact-us . **_NTT DATA endeavors to make_** **_https://us.nttdata.com_** **_accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at_** **_https://us.nttdata.com/en/contact-us_** **_._** **_This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. NTT DATA is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. For our EEO Policy Statement, please click here (http://us.nttdata.com/en/compliance#eeos) . If you'd like more information on your EEO rights under the law, please click here (http://us.nttdata.com/en/compliance#know-your-rights) . For Pay Transparency information, please click here (http://us.nttdata.com/en/compliance#ppnp) ._**