Utilization Management Coordinator

Job Summary

A company is looking for a Utilization Management (UM) Coordinator.

Key Responsibilities

• Support clinical, management, and client activities related to the UM Program
• Process pre-authorizations, claim reviews, and manage case assignments
• Monitor turnaround times and maintain accuracy in processing documentation

Required Qualifications

• High school diploma or GED required
• One or more years of experience in a healthcare-related field, preferably in managed care or utilization review
• Familiarity with UM processes and regulatory requirements
• Experience with software such as CareRadius, CareAfiliate, RightFax, and Orion is a plus
• Ability to work in a fast-paced regulatory environment and support team goals