Oncology Utilization & Authorization Coordinator

American Oncology Partners, PA; Warner Robins (GA); On-site; USD 42,000 - 61,000; Full time

Benefits offered by this job

Ergonomic seating

Flexible schedules

Accessible workstations

Screen reader software

Job summary

American Oncology Network in Central Georgia is seeking a Clinical Utilization Management Coordinator to ensure quality patient care while managing pre-authorizations with payers. You will review medical necessity, coordinate with providers, and keep the clinical team informed on authorization status to avoid treatment delays.

Ideal candidates have an accredited nursing degree with RN or LPN licensure and 2+ years in utilization management, preferably in oncology, plus strong communication and

Qualifications

• Graduate of an accredited nursing program with current RN or LPN licensure.
• Two years LPN or RN experience; oncology preferred.
• Two years experience in utilization management and obtaining insurance authorizations in a medical setting.
• Must have excellent interpersonal and communication skills, be very detail-oriented and a self-starter.

Responsibilities

• Conduct concurrent review to maintain active pre-authorization for scheduled treatments and procedures.
• Review precertification and authorization requests for medical necessity and verify required approvals prior to treatment.
• Monitor treatment plans and other clinical activities that may impact authorizations or require payer approval.
• Communicate with payer plans regarding authorization requirements, coverage determinations, and approvals.
• Provide timely updates to physicians and clinical teams regarding authorization status and payer determinations.
• Escalate authorization barriers or payer-related concerns that may delay or impact treatment.
• Advocate for timely, high-quality patient care while ensuring alignment with payer requirements.

Skills

Communication

Organization

Collaboration

Documentation

Analysis

Advocacy

Travel

Education

RN or LPN licensure

Job description

American Oncology Network in Central Georgia is seeking a Clinical Utilization Management Coordinator to ensure quality patient care while managing pre-authorizations with payers. You will review medical necessity, coordinate with providers, and keep the clinical team informed on authorization status to avoid treatment delays.

Ideal candidates have an accredited nursing degree with RN or LPN licensure and 2+ years in utilization management, preferably in oncology, plus strong communication and