Lead, Care Coordinator

2 years of Utilization Management, Prior Authorization, or Case Management support experience

Advanced knowledge of medical terminology, utilization management, prior authorization, and healthcare benefit processes.

Strong attention to detail and commitment to quality and compliance.

Bilingual (English/Spanish) required.

Lead the daily operations and workflow of the UM Coordinator team to ensure timely processing of authorization requests.

Assist leadership with onboarding, training, mentoring, and ongoing development of new and existing UM Coordinators.

Monitor team productivity, work queues, turnaround times, and workload distribution to ensure compliance with regulatory and organizational standards.

Receive, review, and process incoming requests for authorization of medical services.

Coordinate with providers, members, and internal clinical staff to obtain required documentation for utilization reviews.

Enter authorization requests, updates, and determinations into the utilization management system accurately and efficiently.

NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid.

NeueHealth delivers clinical care to health consumers through our owned clinics – Centrum Health and Premier Medical – as well as unique partnerships with affiliated providers across the country. We also enable providers to succeed in performance-based arrangements through a suite of technology and services scaled centrally and deployed locally. Through our value-driven, consumer-centric approach, we are committed to transforming healthcare and creating a better care experience for all.

The

Lead Utilization Management (UM) Coordinator

provides operational leadership and oversight for the Utilization Management Coordinator team while supporting the coordination, processing, and administrative functions of the utilization review process. This role serves as a subject matter expert, ensuring timely, accurate, and compliant processing of authorization requests in accordance with established clinical guidelines, regulatory requirements, and organizational policies. The Lead UM Coordinator partners closely with UM nurses, physicians, leadership, providers, and other healthcare professionals to promote workflow efficiency, quality outcomes, and exceptional customer service.