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Utilization Management Coordinator
Devoted Health. Manage intake, prior authorization, and clinical coordination workflows .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing intake, prior authorization, and clinical coordination workflows while ensuring accurate documentation and effective communication with providers and members. Proficient in utilizing healthcare systems and EHRs to support operational efficiency and care transitions.
Highest-signal resume keywords
Healthcare Operations ExperienceUtilization Management ProficiencyEHR FamiliarityStrong Organizational SkillsBilingual Communication
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Intake ManagementPrior AuthorizationClinical CoordinationCase Management WorkflowsDocumentation AccuracyOperational ReportingCensus ValidationRFI ManagementDischarge PlanningMedical Record Retrieval
Soft Skills
Effective CommunicationAttention to DetailTime ManagementMultitaskingFollow-Through
Tools & Technologies
Google SheetsGoogle WorkspaceLookerSnowflakeEHR Systems
Industry Keywords
Medicare AdvantageManaged CareHealthcare OperationsUtilization ManagementCare Coordination
Tech Stack
Tools & technologiesSnowflake
About the role
Key responsibilities & impact- 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
What you’ll need- 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
Comp & perks- 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