RN Utilization Management Coordinator — Flexible Scheduling

American Oncology Network; Illinois; On-site; USD 42,000 - 61,000; Full time

Job summary

American Oncology Network is seeking a Clinical Utilization Management Coordinator at Central Georgia Cancer Care to ensure quality care with payer-aligned pre-authorization. You will review patient files, coordinate with payers, and communicate medical necessity positions to providers.

The role emphasizes accurate documentation, timely communication with clinical teams, and adherence to payer requirements, with travel up to 25% and a focus on patient care continuity in a fast-paced oncology

Qualifications

• Graduate of a nursing program with current LPN or RN licensure.
• Two years LPN or RN experience; oncology preferred.
• Two years experience in utilization management and obtaining insurance authorizations.
• Relevant clerical or case management work in a medical setting.
• Excellent interpersonal and communication skills, detail-oriented and self-starter.

Responsibilities

• Conduct concurrent review to ensure active pre-authorization for treatments.
• Review precertification requests for medical necessity and approvals.
• Monitor treatment plans affecting authorizations and payer approvals.
• Communicate payer requirements and coordinate with providers.
• Provide updates to physicians and clinical teams on authorization status.

Skills

Communication

Organization

Collaboration

Documentation

Analysis

Advocacy

Education

RN or LPN licensure

State Licensure

Utilization Management certification preferred

Job description

American Oncology Network is seeking a Clinical Utilization Management Coordinator at Central Georgia Cancer Care to ensure quality care with payer-aligned pre-authorization. You will review patient files, coordinate with payers, and communicate medical necessity positions to providers.

The role emphasizes accurate documentation, timely communication with clinical teams, and adherence to payer requirements, with travel up to 25% and a focus on patient care continuity in a fast-paced oncology