UM Authorization & Care Coordination Specialist

Imperial Health Plan of California, Inc.; Pasadena (CA); On-site; USD 42,000 - 64,000; Full time

Job summary

Imperial Health Plan of California, Inc. is seeking a UM Coordinator in Utilization Management in Pasadena, CA. The role focuses on processing authorizations, ensuring data integrity, and coordinating with Medical Directors, providers, and members to support high-quality care.

The position requires strong written and verbal communication, attention to detail, and adherence to HIPAA regulations. The incumbent will handle inbound/outbound calls, data entry, and compliance with payroll and

Qualifications

• High school diploma or equivalent.
• 1 year of experience required.
• Experience making outgoing calls and taking inquiries.
• Proficiency with Microsoft Office.

Responsibilities

• Process UM authorizations with complete data and timely submission for approval.
• Answer phones and provide customer service to providers and members.
• Print approvals and modification letters from the database daily.
• Scan faxes and attach documents to authorizations in the system.
• Route cases to appropriate personnel in a timely manner.
• Verify duplicate requests and notify the doctor’s office of cancellations.
• Follow up with providers on pending documents within standard turnaround times.

Skills

Communication

Phone calls

Data entry

Teamwork

English

Education

High school diploma or equivalent

Tools

Microsoft Office

Job description

Imperial Health Plan of California, Inc. is seeking a UM Coordinator in Utilization Management in Pasadena, CA. The role focuses on processing authorizations, ensuring data integrity, and coordinating with Medical Directors, providers, and members to support high-quality care.

The position requires strong written and verbal communication, attention to detail, and adherence to HIPAA regulations. The incumbent will handle inbound/outbound calls, data entry, and compliance with payroll and