Hybrid Utilization & Care Coordination Specialist

Taleo; Pearland (TX); Hybrid; USD 25,000 - 44,000; Full time

Benefits offered by this job

Comprehensive benefits package

Stock purchase program

401(k) contribution

Job summary

Kelsey-Seybold Clinic in Pearland seeks an Utilization Management Representative to support Authorization requests, documentation, and coordination across care teams in a hybrid setup.

You will help with utilization review, discharge planning, and liaison between patients, providers, and payers, ensuring accurate records and compliant processes.

Applicants should have 2+ years in managed care, knowledge of medical terminology, Epic experience preferred, and a Texas driver's license.

Qualifications

• 2+ years of managed care experience in a physician office, hospital, health plan, ACO, or similar healthcare environment.
• Knowledge of medical terminology (HMO, PPO, and referral processes).
• Alpha-numeric data entry and basic PC literacy.

Responsibilities

• Process incoming authorization and pre-certification requests.
• Enter and maintain utilization management data in designated systems.
• Support bed day reporting, tracking, and data collection activities.
• Provide clerical and administrative support including filing, faxing, and report generation.
• Coordinate care and discharge planning activities with patients, providers, payers, and internal stakeholders.
• Schedule appointments and assist with service coordination as needed.
• Obtain authorizations for referrals and covered services.
• Verify and document benefit information and payer communications.

Skills

Managed care experience

Medical terminology

Alpha-numeric data entry

Texas Driver's License

Education

High School Diploma or GED

Valid Texas Driver's License

Tools

Epic

Job description

Kelsey-Seybold Clinic in Pearland seeks an Utilization Management Representative to support Authorization requests, documentation, and coordination across care teams in a hybrid setup.

You will help with utilization review, discharge planning, and liaison between patients, providers, and payers, ensuring accurate records and compliant processes.

Applicants should have 2+ years in managed care, knowledge of medical terminology, Epic experience preferred, and a Texas driver's license.