Utilization Management Coordinator

Job Summary

Supporting Utilization Management clinical teams, the contract Utilization Management Coordinator will handle non-clinical administrative tasks related to pre-service authorization and care coordination workflows while working remotely and requiring schedule flexibility, including weekends.

Key responsibilities

• Provide administrative support for member/provider inquiries, including benefit verification and authorization management
• Review incoming authorization requests for initial determination and triage items for clinical review
• Assist with operational problem-solving and data tracking within the department

Required qualifications

• High School Diploma or equivalent
• 3+ years of experience in healthcare claims/service areas or healthcare administrative support
• Ability to work effectively within a multidisciplinary team
• Proficiency with web-based tools and Microsoft Office (Word, Excel, PowerPoint)
• Strong communication, organization, and customer service skills