Utilization Management Specialist

Working remotely or in a hybrid capacity, the full-time Utilization Management Specialist will manage inquiries related to medical and pharmacy reviews, coordinate authorizations, and ensure accurate documentation and communication with internal and external stakeholders. Key responsibilities: Maintain, receive, and verify medical or pharmacy documentation Determine the necessity of medical or pharmacy review decisions and coordinate authorizations Communicate regularly with members, providers, and internal departments to ensure compliance and quality standards Required qualifications: Associate's Degree or equivalent combination of education and experience 1 year of experience in a healthcare-related field Ability to multi-task effectively