Coordinator, UM Intake

Overview

Evolent partners with health plans and providers to achieve better outcomes for patients with complex health conditions. The Coordinator, Intake Utilization Management serves as a point of contact for processing prior authorization requests in accordance with departmental policies, regulatory requirements, and client contractual agreements.

8:30am until 5pm PST with rotating weekends.

• Review internal workflows and policies to determine if submitted requests require a prior authorization review or redirect.
• Enter data into the proprietary system to generate cases for medical and behavioral health reviewers.
• Process requests submitted via fax, email, or provider portal.
• Work directly with physician offices to obtain missing information needed for prior authorization requests.
• Submit IT tickets to address barriers to case generation and follow through to completion.
• Respond to requests promptly and courteously, honoring commitments while persisting in obtaining necessary information.
• Meet established Utilization Management Intake Objectives and Key Results.

• High school diploma or GED.
• 1–3 years of experience in a coordinator role involving prior authorization requests or relevant healthcare experience in claims or appeal & grievance.
• Previous background/experience with oncology.
• Fluent in reading, writing, and speaking English with patients and providers.
• Ability to adapt to fluctuating situations and perform detailed work while avoiding errors.
• Proficient with Windows PC applications and keyboard/navigation skills.
• Team-oriented, strong work ethic, and commitment to productivity.
• Ability to meet goals while balancing workload and prioritizing assignments in a remote environment.
• For call‑center employees:
  High‑speed internet over 10
  
  Mbps and ability to connect directly to the home internet router.
• All candidates must complete a comprehensive background check, in‑person I‑9 verification, and may be subject to drug screening prior to employment.

• Base salary range: $18.00 – $20.00 per hour.
• Comprehensive benefits package, including health insurance, for qualifying employees.

Evolent is an equal‑opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.