Utilization Management Coordinator

Job Summary

Serving as a point of contact for processing prior authorization requests, the full-time remote Utilization Management Coordinator will manage internal workflows, enter data into a proprietary system, and collaborate with clinical teams to ensure compliance with departmental policies and client agreements.

Key responsibilities

• Reviewing workflows to determine the necessity of prior authorization reviews for submitted requests
• Entering data into the system to generate cases for medical and behavioral health reviewers
• Collaborating with physician's offices to obtain required information for prior authorization submissions

Required qualifications

• High school diploma or GED
• 1-3 years of experience in a Coordinator role related to prior authorization requests or relevant healthcare experience
• Previous background or experience with Oncology
• Proficiency in using computer and Windows PC applications
• Demonstrated ability to meet established goals while managing workload in a remote environment