Utilization Management Coordinator

Job Summary

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

Key responsibilities

• Review internal workflows to determine the need for prior authorization reviews and redirect requests as necessary
• Enter data into a proprietary system to generate cases for medical and behavioral health reviewers
• Collaborate with physician's offices to obtain missing information required for prior authorization requests

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/experience with Oncology
• Fluency in reading, writing, and speaking English
• Proficiency in using computer and Windows PC applications