Utilization Management Intake Coordinator- REMOTE

Devoted Health • Waltham, MA

18h • $23 - $28 • Remote

About The Position

The Utilization Management Coordinator plays a vital role in supporting Clinical Operations by managing the intake, prior authorization, and clinical coordination workflows. This role ensures timely case intake, accurate authorization set-up, and effective coordination with members, providers, and internal clinical teams to support care transitions and authorization processes. The coordinator will be an important part of building strong relationships with health care providers through proactive communication, managing key operational processes to enable efficient, high-quality clinical decisions. This is a fast-paced environment at a startup that requires exceptional organization, attention to detail, and a natural talent for customer service. We often require management of several tasks at once so enthusiasm and organization are key.

Requirements

• Experience in healthcare operations, utilization management, care coordination, or prior authorization
• Strong organizational and multitasking skills in a high-volume environment
• Experience working with clinical documentation or medical records
• Proficiency with healthcare systems, EHRs, and reporting tools
• Effective communication skills with providers and members
• A high school diploma - Required
• 1-3 years of administrative or Medical Office experience preferable
• Proficient in technology - Google Sheets and suite of google products- Strongly Preferred

Nice To Haves

• Prior experience in Medicare Advantage or managed care
• Intake, authorization, or clinical coordination experience
• Familiarity with UM or case management workflows
• Bilingual a plus

Responsibilities

• Intake Management Monitor intake queues including census validation checks
• Manage inbound and outbound correspondences
• Ensure referrals and cases are accurately entered into our system or re-routed to delegates as applicable
• Perform authorization set-up and case creation in our systems
• 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; this includes request for information (RFI) work and electronic health record (EHR) access
• Conduct outbound calls to members and providers to obtain clinical information and communicate UM decisions
• Schedule and coordinate Peer-to-Peer (P2P) reviews between providers and Medical Directors
• Manage Medical Director case assignments and tracking
• Retrieve medical records via hospital EHR portals and external systems
• Support the Clinical Team with case coordination and documentation needs
• Contact inpatient and post-acute facilities to confirm admission and discharge details
• Daily census checks
• Assist with discharge planning coordination activities
• Support care transition workflows and case follow-up
• Download operational reports (e.g., Looker, snowflake)
• Support RFIs and case tracking in inpatient/UM tools
• Maintain accurate case status and documentation in our system
• Provide operational and administrative support to the assigned team and manager

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

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED