New York Licensed Utilization Coordinator
VirtualVocationsPasadena, California, United States1 day ago
Job type
- Full-time
Job description
A company is looking for a Utilization Management Coordinator - Compliance.
Key Responsibilities
Review and analyze member cases for medical necessity and appropriateness of treatment authorizations
Conduct internal audits and readiness assessments for accreditation reviews, ensuring compliance with standards
Serve as a liaison between internal and external partners, coordinating documentation and communication for authorization requests
Required Qualifications
Bachelor's degree in nursing
1+ year of fertility nursing experience required
Minimum 2 years of experience in UM compliance or accreditation preparation preferred
Current licensed professional registered nurse
Familiarity with URAC / NCQA standards and state-specific UM regulations
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Utilization Coordinator • Pasadena, California, United States
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