Utilization Management Coordinator

Med Star Family Choice is seeking a detail-oriented and customer-focused Utilization Management Coordinator to provide essential administrative and operational support to our Utilization Management (UM) and Clinical Operations team.

In this role, you will serve as a key liaison between providers, members, and internal clinical staff — ensuring timely authorization intake, accurate documentation, and seamless communication. This position plays a vital role in supporting preauthorization processes, maintaining compliance standards, and helping our clinical team deliver exceptional service to the communities we serve.

• Manage Authorization Intake & Documentation Review and screen incoming clinical documents; build shells for preauthorization and maternity requests; enter accurate data into clinical systems; update case notes; request missing medical documentation; and ensure timely follow-up and “closed-loop” communication.
• Serve as Primary Communication Liaison; professionally manage incoming calls (ACD line coverage), faxes, and correspondence; communicate authorization status to providers and members; disseminate messages appropriately; and represent Med Star Health with professionalism and service excellence.
• Support Clinical Operations & Quality Initiatives; collaborate with UM nurses and interdisciplinary teams; organize data for targeted initiatives; maintain outreach tracking; prepare meeting minutes; participate in service improvement efforts; and support special projects as assigned.
• Ensure Compliance & Operational Excellence; adhere to departmental goals, quality standards, safety protocols, and regulatory requirements while maintaining accurate, timely documentation within clinical systems.

• High School Diploma or GED required
• Associate’s degree preferred

• 1–2 years of clerical or office experience required
• Medical office and/or healthcare customer service experience preferred

• Typing proficiency of 50+ WPM
• Strong Microsoft Office skills (Word & Excel)
• Comfortable navigating multiple computer systems
• Knowledge of medical terminology preferred
• Strong multitasking, prioritization, and organizational skills
• Excellent verbal and written communication skills
• Ability to work independently while collaborating effectively in a team environment

This position has a hiring range of USD $18.70 - USD $32.72 /Hr.