Skills
Prior Authorization
Utilization Management
Healthcare Compliance
About the Role
Astrana Health is hiring a Utilization Management (UM) Coordinator to help the UM team review, track, and process prior authorization requests. You’ll ensure submissions follow regulatory requirements and health plan guidelines while supporting clear communication between providers, members, and internal clinical staff.
Responsibilities
- Coordinate and document medical review activities to confirm services meet criteria for medical necessity, appropriateness, and efficiency
- Review, monitor, and process prior authorization requests in accordance with plan rules
- Serve as a key liaison among providers, members, and internal clinical teams
- Ensure accurate, complete documentation for referrals and authorization decisions
- Provide timely updates and excellent customer service to all stakeholders
- Track request status and support efficient workflows within the UM department
Requirements
- Experience supporting utilization management, prior authorization, or related healthcare administrative processes
- Strong knowledge of documentation and compliance expectations in health plan workflows
- Ability to communicate clearly and professionally with providers and members
- Detail-oriented with a focus on accuracy and timely processing
Benefits
- Mission-driven work with a focus on patient-first care
- Supportive team environment aligned with integrity, excellence, and innovation
- Opportunity to collaborate with care teams and clinical stakeholders
This job was curated and enriched by FindJobHere to help your search. Apply on the original website: careers.astranahealth.com.
Learn how it works.