Care Coordination Specialist - Utilization & Authorization

Centers Plan for Healthy Living; New York (NY); On-site; USD 55,000 - 75,000; Full time

Job summary

Centers Plan for Healthy Living is seeking an Utilization Management Care Coordinator in New York. You will work with a multidisciplinary team to facilitate authorization requests and support member care.

Responsibilities include coordinating with providers and staff, advocating for members, and ensuring compliance with regulations. Strong communication and computer skills are required, with managed care experience preferred.

Qualifications

• Strong written and verbal communication skills.
• Computer proficiency in standard office software.
• Strong multi-tasking abilities.
• Experience in a managed care environment.
• Preferred: proficiency with Microsoft Office applications.

Responsibilities

• Assists in the prior authorization of services and ongoing authorization requests.
• Assists in completing authorization updates as needed per care plan.
• Coordinates with providers regarding authorization activities.
• Coordinates communication between authorization staff, members and providers.
• Acts as liaison and member advocate to ensure timely communication in care.
• Participates in case round meetings and ongoing education.
• Ensures compliance with CPHL and state/federal regulations.
• Other assigned duties.

Skills

Communication skills

Computer proficiency

Multi-tasking

Managed care experience

Education

HS Diploma

Bachelor’s Degree

Tools

Microsoft Office

Job description

Centers Plan for Healthy Living is seeking an Utilization Management Care Coordinator in New York. You will work with a multidisciplinary team to facilitate authorization requests and support member care.

Responsibilities include coordinating with providers and staff, advocating for members, and ensuring compliance with regulations. Strong communication and computer skills are required, with managed care experience preferred.