Utilization Management Coordinator

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family:

• Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance

• Paid Time Off from Day One

• 403-B Retirement Plan

• 4 Weeks 100% Paid Parental Leave

• Career Development

• Whole Person Well-being Resources

• Mental Health Resources and Support

• Pet Benefits

Schedule:

Shift:

Address:

City:

State:

Postal Code:

Job Description:

Posting End Date: November 20, 2026

Responsible for supporting the Utilization Management (UM) team with processing and documenting clinical requests, authorizations, approvals, and denial communications from payors. This position collaborates with interdependent departments to prevent unnecessary delays in patient care, discharge, or billing. This role ensures timely escalation of barriers to appropriate staff and assists in payor communication and coordination as needed.

• Monitors and addresses electronic faxes and emails from payors. Forwards communication to appropriate Utilization Management team members.
• Supports clerical and administrative activities of the Utilization Management team.
• Enters pertinent approval and denial information into the appropriate computer programs for Utilization Management team members to review and address in a timely manner.
• Monitors the Centralized Phone Line for telephonic authorization and denial information from payors.
• Manages and monitors mail from the department mailbox, including uploading letters from payors to patient encounters and forwarding correspondences to applicable departments.
• Tracks and trends payor issues and potential contractual issues, escalating to Utilization Management leadership.
• Manages multiple clerical duties and assigned projects, supporting daily operational flows and special projects as required.
• All other duties as assigned.

Knowledge, Skills, and Abilities:

• Understanding of Microsoft Office Products and other appropriate software platforms [Required]
• Ability to communicate effectively and professionally via phone and email [Required]
• Ability to manage multiple tasks and prioritize level of importance [Required]
• Ability to perform duties in a manner to promote quality patient care and customer service/satisfaction, while promoting safety and a commitment to AH principles [Required]
• Ability to work with people of all social, economic, and cultural backgrounds; be flexible, open-minded and adaptable to change [Required]
• Ability to work with minimal supervision [Required]
• Knowledge of Utilization Management processes [Preferred]
• Knowledge of Care Management processes/workflows [Preferred]

Education:

• Associate [Preferred]
• High School Grad or Equiv [Required]

Field of Study:

• social work

Work Experience:

• Experience in health care, hospital setting, and/or Patient Finance Services [Required]

Physical Requirements: (Please click the link below to view work requirements)

• Physical Requirements - https://tinyurl.com/23km2677

Pay Range:

Background Screening Requirement (Florida Law)

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse:
https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.