Remote Utilization Manager - Payer Authorization

Cedars-Sinai

Central City (CO)

Remote

USD 65,000 - 95,000

Full time

6 days ago

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Benefits offered by this job

Health insurance

Paid time off

403(b) retirement plan

Job summary

Cedars-Sinai is seeking an Utilization Management Specialist to support the UR team in a fast-paced, hospital setting. You will help ensure timely, accurate authorization workflows and regulatory compliance using EPIC/CS-Link and payer portals.

Responsibilities include assembling review packets, tracking payer submissions, and coordinating with UR Nurses, Case Management, and Revenue Cycle to maintain documentation integrity and prevent denials.

Qualifications

Advanced operational and workflow support to UR Nurses in utilization review.
Minimum 2 years in hospital authorization management or UR support roles.
Experience independently managing authorization workflows preferred.
Acute care experience preferred.

Responsibilities

Maintain an assigned portfolio of cases with UR Nurses to support timely utilization review.
Prepare and assemble clinical review packets for payer submission.
Review records to confirm required documentation before submission and escalate gaps.
Track submission confirmations and ensure timely follow-up on determinations.
Manage the authorization lifecycle including entry, tracking, and documentation of determinations.