Utilization Management Coordinator

Job Summary

Supporting Utilization Management operations remotely on a PRN basis, the Utilization Management Coordinator will manage workflow organization, facilitate communication with payers, and assist in the approval processes for admissions while ensuring compliance with departmental standards.

Key responsibilities

• Organizes and prioritizes workflow, manages inbound faxes, and documents EMR/EPIC according to department standards
• Collaborates with UM nurses and external payers to secure necessary approvals and facilitates peer-to-peer reviews as needed
• Handles utilization management clinical requests, escalates patient calls to leadership, and performs additional administrative tasks as assigned

Required qualifications

• High School Diploma or GED required; Associate's Degree preferred
• 1 year of clerical support experience required
• 1 year of administrative support experience in a healthcare field preferred