Utilization Management Support Specialist I

Magellan Health

. Assist in the physician advisor process for cases sent for peer-to-peer review .

Posted 9/15/2026full-timeRemote • United StatesMid-LevelSenior💰 $37,725 - $56,595 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates strong analytical and writing skills while effectively managing customer interactions in a healthcare setting. Proficient in organizing tasks, mentoring team members, and utilizing Microsoft Office applications to support administrative processes.

Highest-signal resume keywords

Healthcare ExperienceStrong Writing SkillsAttention To DetailCustomer InteractionTime Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Document PreparationPeer Review ProcessCase ResearchTask DocumentationClinical Denial Letters

Soft Skills

Interpersonal SkillsOrganizational SkillsAnalytical SkillsMentoringTroubleshooting

Tools & Technologies

Microsoft Office Suite

Industry Keywords

HealthcarePeer-To-Peer ReviewClinical GuidelinesAdministrative SupportApproval Letters

About the role

Key responsibilities & impact

Assist in the physician advisor process for cases sent for peer-to-peer review
Support scheduling of reviews, communicating results, and completing verbal and written correspondence
Research cases referred to peer review and contact facilities to schedule physician-to-physician reviews
Document task completion in applicable internal systems
Prepare administrative, approval, and clinical denial letters
Review completed denial letters for accuracy, template use, and appropriate grade level
Take calls from the designated phone queue when needed
Identify risk situations and escalate them to the supervisor
Troubleshoot case issues by coordinating with internal departments, team members, and physicians
Consult internal departments to ensure cases meet guidelines
Assist in mentoring and training new UM Support Specialists
Perform additional duties assigned by a leader consistent with the job's intent

Requirements

What you’ll need

Experience in customer interactions and detailed review of health-related materials
Strong interpersonal skills and attention to detail
Ability to organize work and seek help on tasks where needed
Ability and willingness to learn new software applications
Strong writing and proofreading skills
Experience in Microsoft Office suite applications
Strong time management skills
Strong analytical skills
Required work experience in healthcare
Associate degree in Business Administration preferred

Benefits

Comp & perks

May be eligible for short-term incentives
Comprehensive benefits package
Health, life, voluntary and other benefits and perks
Benefits and perks supporting physical, mental, emotional and financial wellbeing
Tobacco-free workplace
Equal Opportunity Employer