Utilization Management Coordinator

Job Summary

Supporting the Utilization Management clinical teams, the contract Utilization Management Coordinator will assist with non-clinical administrative tasks related to pre-service, utilization review, care coordination, and quality of care in a fully remote capacity.

Key responsibilities

• Review authorization requests for initial determination and triage for clinical review and resolution
• Provide general support and coordination services, including managing telephone calls and correspondence
• Assist with reporting, data tracking, and organization of information related to the Continuity of Care process and Peer to Peer reviews

Required qualifications

• High school diploma or equivalent
• At least 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 is preferred
• Must reside in D.C., VA, or MD as per client requirement