Utilization Review Coordinator

Title

Utilization Review Coordinator

Regular

Roswell Park Comprehensive Cancer Center

Case Management

Full time

40

1

First Shift (United States of America)

Join a mission-driven team dedicated to delivering high-quality, cost-effective patient care. In this role, you’ll support Case Management and Utilization Management operations by helping ensure patients receive the right care at the right time. Acting as a key liaison between clinical teams, administration, and payers, you will coordinate authorizations, review medical records against established criteria, and manage essential data that supports accurate claims processing.

You’ll collaborate with insurers and providers to strengthen documentation, streamline authorization workflows, and prevent denials — all while maintaining compliance with regulatory standards and organizational policies. This position plays a critical role in advancing efficient, patient-centered services and enhancing the overall care experience.

• Bachelors degree in a health-related field and a minimum of four (4) years of full-time experience in a medical office setting; or
• Associate’s Degree in a health-related field and a minimum of six (6) years of full-time experience in a medical office setting; or
• High School Diploma or High School Equivalency Diploma and a minimum of eight (8) years of full-time experience in a medical office setting.

Note:

Degrees must be conferred by an accredited school, college, or university, or by an institution recognized by Roswell Park Comprehensive Cancer Center and/or Health Research Incorporated as adhering to acceptable educational standards.

Preferred candidates will bring a minimum of 10 years of experience in a medical or physician office setting and a strong understanding of healthcare operations and workflows. Ideal applicants have demonstrated expertise in obtaining and managing insurance authorizations, navigating payer requirements, and ensuring timely approvals. Experience preparing and submitting appeals and managing denials is highly valued, including the ability to identify trends and support resolution efforts.

Candidates should be comfortable communicating with insurance companies to verify benefits, resolve coverage issues, and support accurate claims processing. Proficiency using insurance portals such as Availity is preferred, along with experience working in electronic medical record and care coordination systems including Athena, Roswell EMR, and Careport. A background in healthcare administration or case management, with an understanding of care coordination and utilization processes, is strongly desired.

Roswell Park Cancer Institute Corporation (RPCIC) and Health Research Inc. (HRI) Roswell Park Division believe that all persons are entitled to equal employment opportunities, and we do not discriminate against our employees, applicants or job seekers because of their race, color, religion, sex, sexual orientation, gender identity or expression, national origin, creed, age, disability, pregnancy-related condition, military or veteran status, marital or familial status, domestic violence victim status, citizenship status, genetic information, individual’s relationship or association with a member of a protected category or any other protected group status as defined by law.

RPCIC and HRI are committed to working with and providing reasonable accommodation to individuals with disabilities. If, because of a medical condition or disability, you need a reasonable accommodation for any part of the employment process, please email HR-Pay And Benefits  and let us know the nature of your request and your contact information.

RPCIC and HRI are committed to providing an environment where patients, families, employees and community are treated with courtesy and respect. We support an inclusive environment that nurtures the talents, skills and abilities of each individual to embody and reflect our core values:
Innovation, Integrity, Teamwork, Commitment, Compassion and Respect.

Pursuant to Executive Order 161, no State entity, as defined by the Executive Order, is permitted to ask, or mandate, in any form, that an applicant for employment provide his or her current compensation, or any prior compensation history, until such time as the applicant is extended a conditional offer of employment with compensation. If such information has been requested from you before such time, please contact the Governor’s Office of Employee Relations at  or via email .