Utilization Management Coordinator

About Altais:

At Altais, we're on a mission to improve the healthcare experience for everyone-starting with the people who deliver it. We believe physicians should spend more time with patients and less time on administrative tasks. Through smarter technology, purpose-built tools, and a team-based model of care, we help doctors do what they do best: care for people.


Altais includes a network of physician-led organizations across California, including Brown & Toland Physicians, Altais Medical Group Riverside, and Family Care Specialists. Together, we're building a stronger, more connected healthcare system.


About the Role

Are you looking to join a fast-growing, dynamic team?

We're a collaborative, purpose-driven group that's passionate about transforming healthcare from the inside out. At Altais, we support one another, adapt quickly, and work with integrity as we build a better experience for physicians and their patients.

As a UM Coordinator, you will work closely with our Ambulatory and Concurrent Care, Network Management, Quality Improvement and Practice Success teams. Your responsibilities include driving efficient authorization processes, navigating insurance requirements with precision and advocacy. We seek individuals with a strong commitment to patient-centered care and a passion for promoting health and wellness.


You will focus on:

• Responsible for all incoming authorizations, whether received via Tapestry Link portal or OnBase. Authorizations may require eligibility or benefit verification and data entry into Tapestry before processing and are governed by established Turn Around Times (TAT) consistent with the Industry Collaboration Effort (ICE) regulations.
  
  

• Function as the primary contact for internal and external customers requesting information or assistance related to authorizations.
  
  

• Review authorization requests per established level of review designation.
  
  

• Prepare the denial letters under the supervision of the professional staff. Works closely with professional staff and customer service to provide accurate technical information to provider offices and internal customers in a professional manner.
  
  

• Contact provider offices by telephone for missing clinical documentation necessary for medical review and document information requested in Tapestry.
  
  

• Cross train with all UM Coordinators to learn each process completely to ensure coverage is available.
  
  

• Ensure strict confidentiality of all health records, member information and meet HIPAA guidelines.
  
  

The Skills, Experience & Education You Bring

• High school diploma
  
  
• Two years previous UM experience, medical records, medical billing, or medical office experience.
  
  

• 2-3 years Microsoft Office programs experience required.
  
  

• Certificate or equivalent experience in medical terminology, CPT, HCPCS, and ICD coding required.
  
  

The Base Salary for this position is $25.00 - $30.00/hr

In addition, we provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs.

• Excellent medical, vision, and dental coverage
  
• 401k savings plan with a company match
  
• Flexible time off and 9 Paid Holidays
  

You Share Our Mission & Values:


Compassion


We act with empathy and a deep respect for the challenges faced by physicians and their patients. Our work is driven by a genuine commitment to improving lives and ensuring that care is delivered with dignity, understanding, and humanity.


Community


We foster a culture of collaboration--with physicians, patients across the healthcare ecosystem, and among our teams. By building strong, trusted relationships, we create a unified community focused on advancing patient care and physician well-being.


Leadership


We lead with integrity and vision, setting the standard for excellence in physician support and healthcare innovation. Through collaboration and expertise, we empower others to lead, drive change, and shape the future of care.


Excellence


We are relentlessly focused, results-driven, and accountable for delivering measurable value to physicians and the patients they serve. Our high standards reflect our commitment to excellence, operational discipline, and continuous improvement.


Agility


We embrace change as a constant and respond swiftly to the evolving needs of the healthcare industry. With flexibility and forward-thinking, we adapt, innovate, and act decisively to keep physicians at the forefront.

Altais values the contribution each Team Member brings to our organization. Final determination of a successful candidate's starting pay will vary based on several factors, including, but not limited to education and experience within the job or the industry. The pay scale listed for this position is generally for candidates that meet the specified qualifications and requirements listed on this job description. Additional pay may be determined for those candidates that exceed these specified qualifications and requirements. We provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs.

The anticipated pay range for this role is listed in our salary posting for transparency but may vary based on factors including the candidate's qualifications, skills, and experience. This position will also be eligible to participate in our annual bonus program.

Altais and its subsidiaries and affiliates are committed to protecting the privacy and security of the personal information you provide to us. Please refer to our 'CPRA Privacy Notice for California Employees and Applicants' to learn how we collect and process your personal information when you apply for a role with us.

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.