Massachusetts Licensed Inpatient UM Specialist

Job Summary

Detail-oriented and customer-focused, the Massachusetts Licensed Inpatient UM Specialist will manage authorization requests, communicate with providers and members, and maintain compliance in a fully remote contract role.

Key responsibilities

• Process and prioritize authorization requests ensuring timely and accurate completion
• Communicate with providers, members, and internal teams to gather information and resolve inquiries
• Review documentation for completeness and route cases requiring clinical review to appropriate resources

Required qualifications

• Associate degree in Healthcare, Social Work, or a related field; equivalent experience considered
• Three or more years of experience in healthcare administration, prior authorization, or utilization management support
• Experience working with healthcare systems, databases, or payer platforms preferred
• Strong organizational skills with the ability to manage high-volume workloads and meet deadlines
• Excellent customer service, communication, and Microsoft Office proficiency