Utilization Management Coordinator
Core
Manage intake, prior authorization, and clinical coordination workflows to support care transitions and authorization processes for members and providers.
Role type
Utilization Management Coordinator
Builds
Efficient, high-quality clinical decisions and care transition workflows
Domain
Healthcare / Utilization Management
Required skills
Healthcare operations experience, Prior authorization, EHR proficiency, Clinical documentation review, Outbound communication, Case tracking
Preferred skills
Medicare Advantage experience, Google Sheets proficiency, Bilingual
Technologies
Looker, Snowflake, EHR portals, Google Workspace
Responsibilities
Monitor intake queues and validate daily census, Perform authorization set-up and case creation, Conduct outbound calls to members and providers, Schedule peer-to-peer reviews, Retrieve medical records via EHR portals, Complete discharge planning coordination
Seniority
Entry-level to Mid-level, hands-on IC