UM Care Coordinator & Authorization Advocate

Centers Plan for Healthy Living; Florida; On-site; USD 42,000 - 63,000; Full time

Job summary

Centers Plan for Healthy Living in Florida is seeking a Utilization Management Care Coordinator to join a multidisciplinary care team. You will assist with authorization requests for members in the Managed Long Term Care program and help ensure timely communication with providers and members.

The role emphasizes collaboration with providers, liaison work with care teams, and ensuring compliance with state and federal regulations. Strong communication and computer skills are essential for success.

Qualifications

• HS Diploma required.
• Bachelor’s degree preferred.
• Strong written and verbal communication skills.
• Experience working in a managed care environment preferred.
• Proficiency with Microsoft Office applications.

Responsibilities

• Assists in the prior authorization of services and ongoing authorization requests.
• Assists in completing authorization updates as needed based on the care plan.
• Coordinates with providers regarding authorization activities.
• Coordinates communication between authorization staff, members and providers.
• Acts as liaison and advocate between member/family, physicians and care team.
• Participates in case rounds meetings and ongoing education.
• Ensures all duties comply with CPHL and state/federal regulations.
• Other assigned duties.

Skills

Strong written and verbal communicatie

Computer proficiency

Multi-tasking abilities

Education

HS Diploma

Bachelor's Degree

Tools

Microsoft Office

Job description

Centers Plan for Healthy Living in Florida is seeking a Utilization Management Care Coordinator to join a multidisciplinary care team. You will assist with authorization requests for members in the Managed Long Term Care program and help ensure timely communication with providers and members.

The role emphasizes collaboration with providers, liaison work with care teams, and ensuring compliance with state and federal regulations. Strong communication and computer skills are essential for success.