Utilization Management Coordinator I — Impact Healthcare

PacificSource; North Carolina; Hybrid; USD 36,000 - 57,000; Full time

Job summary

PacificSource is seeking an Utilization Management (UM) Coordinator I to support the UM team by researching and coordinating initial and follow-up clinical documentation requests. You will ensure regulatory compliance and collaborate with care teams to improve member outcomes.

This entry-level role requires attention to detail, strong communication, and the ability to work across multiple systems. Travel is minimal; the position emphasizes privacy, accuracy, and member-centered service.

Qualifications

• Minimum two years of health insurance or medical setting experience.
• Basic CPT/HCPCS/ICD coding knowledge preferred.
• Strong written and verbal communication skills.

Responsibilities

• Adhere to dependability, member and provider focus, and performance criteria.
• Coordinate and document UM cases in the electronic record.
• Validate preauthorization requirements and coding accuracy.
• Collaborate with clinical staff across UM/CM and care management.
• Manage HIPAA-compliant member communications and inquiries.
• Escalate complex calls and triage to senior staff.

Skills

Accountability

Collaboration

Communication

Flexibility

Listening

Organization & Planning

Problem Solving

Teamwork

Education

HS diploma

Associate degree

Medical assistant cert

Nurse license

CPC certification

Job description

PacificSource is seeking an Utilization Management (UM) Coordinator I to support the UM team by researching and coordinating initial and follow-up clinical documentation requests. You will ensure regulatory compliance and collaborate with care teams to improve member outcomes.

This entry-level role requires attention to detail, strong communication, and the ability to work across multiple systems. Travel is minimal; the position emphasizes privacy, accuracy, and member-centered service.