Utilization Management Assistant

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Utilization Management Assistant in the United States.

This role sits at the heart of utilization management operations, ensuring smooth coordination of administrative, clinical, and payer-related processes that support timely and accurate patient care decisions. You will act as a key liaison between internal teams, physicians, and insurance providers, helping to maintain compliance with payer requirements and streamline communication workflows. Working in a fast-paced healthcare environment, you will manage sensitive and confidential information with precision and professionalism. The position plays a critical role in ensuring admissions, authorizations, and discharge processes are properly documented and communicated. You will collaborate closely with utilization nurses and other clinical staff to support efficient case management. This is a highly detail-oriented role where accuracy, organization, and responsiveness directly impact patient outcomes and operational effectiveness.

Accountabilities

In this role, you will provide essential administrative and coordination support to the utilization management team, ensuring that payer communication and documentation processes are completed accurately and on time. You will manage daily office operations, support clinical staff workflows, and maintain compliance with insurance and hospital requirements.

• Perform key administrative functions such as answering and triaging calls, assisting with insurance communications, maintaining supplies, and collecting/verifying documentation from multiple sources.
• Support utilization nurses by ensuring timely transmission of clinical and administrative information to payers, including authorizations, denials, and peer-to-peer updates.
• Ensure accurate tracking of admissions, discharges, and payer notifications in alignment with insurance requirements and organizational standards.
• Perform release of information tasks while handling highly sensitive and confidential patient data in compliance with regulations.
• Maintain and update utilization management systems, SharePoint resources, and payer information databases to ensure accuracy and accessibility.
• Monitor work queues, fax completion, and insurance discrepancies while escalating issues to appropriate clinical staff.
• Serve as a knowledgeable resource for insurance portals and payer-related processes while fostering effective communication with physicians and care teams.

Requirements

The ideal candidate brings strong healthcare administrative experience, excellent organizational skills, and the ability to manage multiple priorities in a structured and detail-driven environment. You are comfortable working with sensitive information and collaborating across clinical and administrative teams.

• High School Diploma or GED required.
• Minimum of 3 years of healthcare experience in administrative, clinical support, or utilization-related roles.
• Strong understanding of healthcare operations, insurance processes, and payer communication workflows.
• Excellent communication, teamwork, and problem-solving skills in a fast-paced environment.
• Ability to multitask, prioritize work queues, and maintain high accuracy under deadlines.
• Experience handling confidential information with professionalism and discretion.
• Proficiency in office systems, healthcare platforms, and documentation tools.

Benefits

• Comprehensive health, dental, and vision insurance starting on day one
• Multiple medical plan options, including expanded coverage for dependents
• 401(k) retirement plan with employer contributions
• Paid time off with generous accrual policies
• Health savings and flexible spending accounts (HSA/FSA) with employer support
• Life, short-term, and long-term disability insurance fully covered by employer
• Tuition reimbursement up to $5,000 annually
• Employee wellness and rewards programs
• Family support benefits including parental leave, adoption and fertility assistance, and caregiving resources
• Employee assistance program offering mental health, legal, childcare, and eldercare support
• Additional voluntary benefits such as identity protection and supplemental insurance options

How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best! Why Apply Through Jobgether? Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time. #LI-CL1