Remote Utilization Management Specialist

Devoted Health Services; United States; Remote; USD 30,000 - 37,000; Full time

Job summary

Devoted Health Services is seeking an Utilization Management Coordinator to support clinical operations with intake, authorization setup, and care coordination across members, providers, and internal teams.

This full-time, remote role emphasizes meticulous organization, proactive communication, and the ability to navigate a regulated UM environment, including CMS audits and research support.

Qualifications

• High school diploma or equivalent.
• Experience in healthcare operations, utilization management, care coordination, or prior authorization.
• Proficiency with healthcare systems, EHRs, and reporting tools.
• Effective communication with providers and members.
• Strong organizational and multitasking skills in a high-volume environment.
• Attention to detail, follow-through, and time management in a frequently changing environment.

Responsibilities

• Monitor intake queues and daily census validation checks.
• Perform authorization set-up and case creation in our systems; manage inquiries across multiple case types.
• Conduct outbound calls to obtain clinical information and communicate UM decisions; schedule peer-to-peer reviews.
• Retrieve medical records via hospital EHR portals and external systems; support case coordination.
• Complete daily census checks and assist with discharge planning coordination activities.

Skills

Healthcare operations

Utilization management

Care coordination

Prior authorization

Communication

Organization

Time management

Education

High school diploma or equivalent

Tools

EHRs

Looker

Snowflake

Google Sheets

Google Workspace

Job description

Devoted Health Services is seeking an Utilization Management Coordinator to support clinical operations with intake, authorization setup, and care coordination across members, providers, and internal teams.

This full-time, remote role emphasizes meticulous organization, proactive communication, and the ability to navigate a regulated UM environment, including CMS audits and research support.