Utilization Management Coordinator

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $21 - $27 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Devoted Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2017

🏥 Healthcare

⚕️ Healthcare Insurance

🧘 Wellness

Healthcare • Healthcare Insurance • Wellness

Devoted Health is a healthcare company that offers Medicare Advantage plans designed to provide comprehensive health coverage with added benefits like dental, eyewear, gym memberships, and prescription drugs at competitive rates. The company emphasizes member support and service, ensuring that clients can easily navigate their benefits and access needed healthcare services. Devoted Health is committed to helping customers save money and enhance their health and wellness through a complete package of benefits and support.

📋 Description

• Manage intake, prior authorization, and clinical coordination workflows • Monitor intake queues, including daily census validation checks • Manage inbound and outbound correspondence • Enter referrals and cases accurately into systems or re-route them to delegates • Perform authorization set-up and case creation • Manage and resolve authorization-related inquiries across multiple case types • Review member inpatient status and clinical documentation to support episode updates • Ensure required documentation is present for clinical review and determination, including RFI work and EHR access • Conduct outbound calls to members and providers to obtain clinical information and communicate UM decisions • Schedule and coordinate peer-to-peer reviews between providers and Medical Directors • Manage Medical Director case assignments and tracking • Retrieve medical records via hospital EHR portals and external systems • Support clinical case coordination and documentation needs • Contact inpatient and post-acute facilities to confirm admission and discharge details • Complete daily census checks and assist with discharge planning coordination • Support care transition workflows and case follow-up • Download and review operational reports, including Looker and Snowflake • Support RFIs and case tracking in inpatient and UM tools • Maintain accurate case status and documentation • Provide operational and administrative support to the assigned team and manager • Participate in research and root-cause analysis during periodic CMS audits

🎯 Requirements

• High school diploma or equivalent • Experience in healthcare operations, utilization management, care coordination, or prior authorization • Proficiency with healthcare systems, EHRs, and reporting tools • Effective communication skills with providers and members • Strong organizational and multitasking skills in a high-volume environment • Attention to detail, follow-through, and time management in a frequently changing environment • Prior experience in Medicare Advantage or managed care • Intake, authorization, or clinical coordination experience • Familiarity with UM or case management workflows • 1–3 years of administrative or medical office experience • Proficiency with Google Sheets and the Google Workspace suite • Bilingual

🏖️ Benefits

• Employer sponsored health, dental and vision plan with low or no premium • Generous paid time off • $100 monthly mobile or internet stipend • Stock options for all employees • Bonus eligibility for all roles excluding Director and above • Commission eligibility for Sales roles • Parental leave program • 401K program

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