Utilization Management Coordinator

Supporting Clinical Operations in a full-time remote capacity, the Utilization Management Coordinator will manage intake, prior authorization, and clinical coordination workflows to ensure timely case processing and effective communication with members and providers. Key responsibilities Monitor intake queues and manage inbound/outbound correspondence to ensure accurate case entry Perform authorization set-up and manage authorization-related inquiries while ensuring required documentation is present for clinical review Conduct outbound calls to members and providers for clinical information and coordinate peer-to-peer reviews Required qualifications High school diploma or equivalent Experience in healthcare operations, utilization management, care coordination, or prior authorization Proficiency with healthcare systems, EHRs, and reporting tools Strong organizational and multitasking skills in a high-volume environment Attention to detail and time management in a frequently changing environment