Utilization Management Coordinator

Job Summary

To support a growing healthcare team, the full-time Utilization Management Coordinator will manage member support, prior authorization coordination, and administrative case management tasks in a fully remote environment.

Key responsibilities

• Serve as the primary point of contact for members seeking assistance with healthcare navigation and coordinate care-related inquiries
• Process incoming prior authorization requests and ensure timely communication with provider offices regarding case status and documentation
• Assist in coordinating post-acute services and track assigned cases to completion, escalating clinical concerns as necessary

Required qualifications

• High school diploma or equivalent required; associate degree in healthcare administration or related field preferred
• Minimum of 2 years of experience in healthcare administration, utilization management support, or related healthcare setting
• Experience with prior authorization processes and provider communication preferred
• Proficiency in Microsoft Office Suite and healthcare information systems
• Knowledge of medical terminology and understanding of health insurance and utilization management workflows preferred