Utilization Management Coordinator

Job Summary

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

Key responsibilities

• Provide member/provider administrative support, including benefit verification and authorization management
• Review incoming authorization requests for initial determination and triage items for clinical review
• Assist with reporting, data tracking, and organizing information related to Continuity of Care processes

Required qualifications

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