Clinical Utilization Coordinator (RN/OT/PT/MSW)

ADP, Inc.; Pittsburgh (Allegheny County); On-site; USD 70,000 - 84,000; Full time

Job summary

Community LIFE is seeking an experienced Utilization Management Coordinator to coordinate utilization management across all levels of care at our Pittsburgh base (Forest Hills 15221). The role supports clinical decision-making and coordinates with RN Case Managers and IDT to ensure appropriate levels of care across transitions.

Hours are 7:30am–4:00pm, Mon–Fri. The candidate will have 3+ years in utilization review or related case management, with PA licensure in the applicable fields.

Qualifications

• RN licensure in PA with BSN or equivalent
• PT license in PA or PT degree
• OT license in PA
• COTA/L license in PA
• MSW degree

Responsibilities

• Coordinate utilization management across all levels of care
• Support hospital and nursing facility service authorization processes
• Interpret clinical information to determine medical necessity and appropriate levels of care
• Collaborate with RN Case Managers and the IDT across clinical and community settings
• Ensure timely documentation and reporting of utilization decisions

Skills

Clinical interpretation

Attention to detail

Time management

Interdisciplinary collaboration

Licensure knowledge

Education

BSN with PA RN licensure

PT license (PA)

PTA license (PA)

OT license (PA)

COTA/L license (PA)

MSW

Tools

Outlook

Word

PowerPoint

Excel

Job description

Community LIFE is seeking an experienced Utilization Management Coordinator to coordinate utilization management across all levels of care at our Pittsburgh base (Forest Hills 15221). The role supports clinical decision-making and coordinates with RN Case Managers and IDT to ensure appropriate levels of care across transitions.

Hours are 7:30am–4:00pm, Mon–Fri. The candidate will have 3+ years in utilization review or related case management, with PA licensure in the applicable fields.