Utilization Management Technician

The primary responsibility of the Utilization Management Technician is to maintain standard compliance and performance-related utilization management data. This role involves processing daily, weekly, and monthly utilization management reports, establishing and maintaining efficient filing systems in both paper and electronic formats. The technician also maintains Health Plan audit tools, including the distribution and collection of data and documentation, assists in data collection for all Health Plan audits, and compiles necessary data for NCQA, DMHC, and CMS focused audits, as well as unplanned audits of the delegated Medical Group as downstream providers. Additional duties include answering and screening phone calls, updating payer authorizations, working on denials, monitoring faxes and inputting data into Epic and Genesis, working in provider portals such as Availity, and sending clinicals to payers.

Responsibilities

• Maintain standard compliance and performance-related utilization management data.
• Process daily, weekly, and monthly utilization management reports.
• Establish and maintain efficient filing systems in paper and electronic formats.
• Maintain Health Plan audit tools, including data distribution and collection.
• Assist in data collection for Health Plan audits and compile data for NCQA, DMHC, and CMS focused audits.
• Answer and screen phone calls.
• Update payer authorizations.
• Work on denials.
• Monitor faxes and input data into Epic and Genesis.
• Work in provider portals such as Availity.
• Send clinicals to payers.

• Proficiency with the entire Microsoft Suite (Word, Excel, Teams, PowerPoint, Access).
• Experience with Epic.
• Strong analytical and utilization modeling skills using data from referral, beddays, and claims databases.
• Strong interpersonal and professional communication skills.
• Knowledge of the managed healthcare marketplace, health delivery systems, and contract basics.
• Beginning knowledge of CMS, NCQA, DMHC, ADA, and HIPAA regulations.

• Associate's Degree.
• Experience in managed care and utilization review.
• Understanding of HIPAA regulations.
• Comfortable working in Teams to communicate with co-workers remotely.

The work environment involves using technologies like Epic and Genesis, and requires proficiency in the Microsoft Suite. It is essential to be comfortable working in teams and communicating with co-workers remotely.

Job Type & Location

This is a Contract position based out of Everett, WA.

The pay range for this position is $23.00 - $28.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

This is a hybrid position in Everett,WA.

This position is anticipated to close on Apr 20, 2026.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I is embedded into our culture through:

• Hiring diverse talent
• Maintaining an inclusive environment through persistent self-reflection
• Building a culture of care, engagement, and recognition with clear outcomes
• Ensuring growth opportunities for our people

Actalent is an equal opportunity employer.

About Actalent

Actalent is a global leader in engineering and sciences services. For more than 40 years, we’ve helped visionary companies advance their goals. Headquartered in the United States, our teams span 150 offices across North America, EMEA, and APAC—with four delivery centers in India led by 1,000+ extraordinary employees who connect their passion with purpose every day.

Our Bangalore, Hyderabad, Pune, and Chennai delivery centers are hubs of engineering expertise, with core capabilities in mechanical and electrical engineering, systems and software, and manufacturing engineering. Our teams deliver work across multiple industries including transportation, consumer and industrial products, and life sciences. We serve more than 4,500 clients, including many Fortune 500 brands. Learn more about how we can work together at actalentservices.com.