What are the responsibilities and job description for the Utilization Management Coordinator position at Actalent?
Job Title: Utilization Management Coordinator
Job Description
As a Utilization Management Coordinator, you will coordinate and support activities related to authorization processing for outpatient, inpatient, and ambulatory services. Your role will involve compiling daily inpatient logs, reviewing specified utilization management reports, processing referrals, completing denial letters, and performing retro-review coordination. You will also coordinate quality management grievances, activities, quality of care concerns, and CCS-related activities. Acting as a liaison to providers’ offices and UM/QM staff, you will provide clerical assistance and prepare reports for the UM/QM Supervisor, Manager, and/or Director of Medical Management.
Responsibilities
- Coordinate and support authorization processing for outpatient, inpatient, and ambulatory services.
- Compile daily inpatient logs and review specified utilization management reports.
- Process referrals and complete denial letters.
- Perform retro-review coordination.
- Coordinate quality management grievances, activities, quality of care concerns, and CCS-related activities.
- Act as a liaison to providers’ offices and UM/QM staff.
- Provide clerical assistance and prepare reports for the UM/QM Supervisor, Manager, and/or Director of Medical Management.
Essential Skills
- Experience in healthcare and care coordination.
- IPO/HMO experience.
- Three years of customer service experience.
- Two years of Medicare health plan knowledge.
- HMO/IPA experience.
Additional Skills & Qualifications
- Experience in healthcare and care coordination.
- IPO/HMO experience.
- Medicare experience
- Experience in referrals
Work Environment
The position offers a Monday to Friday day shift in an office setting at the corporate location. The work environment includes dual screens to aid in efficient task management.
Job Type & Location
This is a Contract position based out of Sacramento, CA.
Pay and Benefits
The pay range for this position is $22.00 - $23.00/hr.
Eligibility requirements apply to some benefits and may depend on your job
classification and length of employment. Benefits are subject to change and may be
subject to specific elections, plan, or program terms. If eligible, the benefits
available for this temporary role may include the following:
• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully onsite position in Sacramento,CA.
Application Deadline
This position is anticipated to close on Dec 6, 2025.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.
Salary : $22 - $23