Healthcare Utilization Coordinator

2 weeks ago


Owings Mills, Maryland, United States System One Holdings, LLC Full time

System One Holdings, LLC is seeking a dedicated Utilization Management Coordinator to assist a prominent health insurance provider. This role involves supporting the Utilization Management clinical teams through various non-clinical administrative functions associated with pre-service, utilization assessment, care coordination, and quality assurance.

Compensation: $24/HR
Work Arrangement: 100% Remote
Location Requirement: Must reside in DMV

Key Responsibilities:

  • Evaluate authorization requests for initial assessment and/or directs them for clinical evaluation and resolution.
  • Offer comprehensive support and coordination services for the department, which includes managing phone inquiries, taking messages, handling correspondence, researching information, and assisting in problem resolution.
  • Contribute to reporting, data management, and the organization and dissemination of information related to the Continuity of Care process and tracking of Peer to Peer reviews.
  • Provide administrative support related to members or providers.


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