Utilization Management Coordinator

Job Summary

Supporting a leading health insurance customer, the contract Utilization Management Coordinator will manage non-clinical administrative tasks related to pre-service, utilization review, care coordination, and quality of care while working remotely.

Key responsibilities

• Review authorization requests for initial determination and triage for clinical review and resolution
• Provide general support and coordination services, including answering calls and researching information
• Assist with reporting, data tracking, and dissemination of information related to the Continuity of Care process

Required qualifications

• High school diploma or equivalent
• One year of experience in a healthcare or managed care setting
• Call center experience with the ability to manage a high volume of calls
• Familiarity with CPT and ICD-10 coding preferred
• Ability to work effectively in a remote environment