Remote Utilization & Care Coordination Specialist

Blue Zones Health; California; Remote; USD 34,000 - 43,000; Full time

Job summary

Blue Zones Health is seeking a remote Utilization Management Coordinator to support inpatient and outpatient UM teams within an IPA. The role focuses on administrative, operational, and care coordination tasks, ensuring timely authorizations and effective transitions of care.

The ideal candidate is highly organized, detail-oriented, capable of managing multiple priorities, and compliant with HIPAA and regulatory requirements.

Qualifications

• Minimum 2 years in healthcare administration or UM operations.
• Experience with authorization processes and managed care.
• Familiarity with CMS/DMHC/NCQA guidelines encouraged.

Responsibilities

• Receive, process, and track inpatient admission notifications.
• Review and process outpatient authorization requests (routine and urgent).
• Coordinate transitions of care and discharge planning.
• Maintain accurate UM documentation and records.
• Communicate with providers, hospitals, and health plans regarding status and requirements.
• Monitor authorization queues and escalate deadlines as needed.
• Provide cross-coverage for inpatient and outpatient UM workflows.

Skills

Healthcare administration

Communication

Multitasking

Remote work

Education

High School Diploma

Associate degree in Healthcare Administration

Medical Assistant certification (preferred)

Tools

Microsoft Office

EMR Systems

Job description

Blue Zones Health is seeking a remote Utilization Management Coordinator to support inpatient and outpatient UM teams within an IPA. The role focuses on administrative, operational, and care coordination tasks, ensuring timely authorizations and effective transitions of care.

The ideal candidate is highly organized, detail-oriented, capable of managing multiple priorities, and compliant with HIPAA and regulatory requirements.