UM Coordinator (Work from home)
$40,082–$60,133 year
Remote · California, United States
Job Summary
UM Coordinator handles coordination and processing of utilization reviews, reviewing requests for authorization of medical services, and serving as liaison among providers, members, and internal clinical staff. Responsibilities include entering and tracking authorization requests in the UM system, ensuring timely determinations, maintaining compliant records for accreditation and regulatory bodies (e.g., NCQA, CMS), assisting with audits and quality improvement activities, and ensuring HIPAA confidentiality. The role requires strong medical terminology knowledge, proficiency with medical management systems (e.g., MCG), and excellent communication and organizational skills; bilingual English/Spanish is preferred. The position offers a California remote work arrangement with compensation estimated between $40,082 and $60,133 annually.
Required Qualifications
- High School Diploma or equivalent required
- 2+ years of experience in health plan environment; experience in utilization management or case management support strongly preferred
Desired Qualifications
- High School Diploma or equivalent required
- Associate’s degree or healthcare certification preferred
- 2+ years of experience in health plan environment; experience in utilization management or case management support strongly preferred
- Bilingual Preferred (English/ Spanish)
- Certification As A Medical Assistant Preferred
- Strong knowledge of medical terminology and healthcare authorization processes
- Proficient in Microsoft Office Suite and medical management systems (e.g., MCG, or similar UM platforms)
- Excellent communication, organization, and customer service skills
- Ability to work independently and manage multiple priorities in a fast-paced environment
Apply with one swipe on Sorce. We auto-fill applications and apply on your behalf — no cover letters, no 40-minute forms.
Hiring someone like this?
Get your role in front of qualified candidates on Sorce.