Job Description

Schedule:

This role supports our weekend operations and requires availability every Saturday and Sunday. The weekly schedule is a 5-day (8-hour) schedule, totaling 40 hours per week. Shifts are scheduled within the hours of 8:00 AM–8:00 PM ET.

A bit about this role:

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.

Core Responsibilities: Intake, Clinical Coordination & Prior Authorization

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

Prior Authorization Support

• 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

Clinical Coordination & Communication

• 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

Post-Discharge & Transitional Care Coordination

• 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

Operational & Reporting Support

• 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

Required skills and experience:

• 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

Desired skills and experience:

• Prior experience in Medicare Advantage or managed care

• Intake, authorization, or clinical coordination experience

• Familiarity with UM or case management workflows

• 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

• Bilingual a plus

Key Competencies:

• Workflow coordination

• Attention to detail

• Communication & follow-through

• Clinical operations support

• Time management

• Collaboration with clinical teams

• Ability & agility to multitask

#LI-Remote

Salary Range: $22.50 - $27.50 / hour

The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Our Total Rewards package includes:

• 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

• And more....

*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

Healthcare equality is at the center of Devoted’s mission to treat our members like family. We are committed to a diverse and vibrant workforce.

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States. And we've just started. So join us on this mission!

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.