Utilization Management Coordinator

UnitedHealth Group; Pearland (TX); On-site; USD 25,000 - 44,000; Full time

Benefits offered by this job

Comprehensive benefits

Incentive programs

Equity stock purchase

401k contribution

Job summary

Kelsey-Seybold Clinic, part of the Optum family and UnitedHealth Group, is hiring an Utilization Management Representative to support UM and Population Health across multiple sites in the Houston area. The role handles authorization requests, maintains records, coordinates services, and liaises with patients, providers, payers, and care teams.

Responsibilities include processing authorizations, data entry, bed day reporting, discharge planning support, and referral coordination.

Qualifications

• High School Diploma or GED is required.
• 2+ years of managed care experience in a physician office, hospital, health plan, ACO, or similar healthcare environment.
• Knowledge of medical terminology (HMO, PPO, and referral processes).
• Alpha-numeric data entry and basic PC literacy.
• Proven excellent time management skills.
• Valid Texas Driver's License.
• Experience with CPT and ICD-10 coding methodologies is preferred.

Responsibilities

• Process incoming authorization and pre-certification requests.
• Enter and maintain utilization management, admission, discharge, and clinical information in designated systems.
• Support bed day reporting, tracking, and data collection activities.
• Provide clerical and administrative support including filing, faxing, correspondence management, and report generation.
• Coordinate care and discharge planning activities with patients, providers, payers, and internal stakeholders.
• Schedule appointments and assist with service coordination as needed.
• Obtain authorizations for referrals and covered services.
• Verify and document benefit information and payer communications.

Skills

Time management

Data entry

Medical terminology

Payer communications

Education

High School Diploma or GED

Tools

Epic

Job description

Kelsey-Seybold Clinic, part of the Optum family and UnitedHealth Group, is hiring an Utilization Management Representative to support UM and Population Health across multiple sites in the Houston area. The role handles authorization requests, maintains records, coordinates services, and liaises with patients, providers, payers, and care teams.

Responsibilities include processing authorizations, data entry, bed day reporting, discharge planning support, and referral coordination.