Coordinator I, Utilization Management

If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day.

This Coordinator I of Utilization Management is responsible for providing support to the Medical Management department to ensure the timeliness of outpatient or inpatient referral/authorization processing per state and federal guidelines. This position performs troubleshooting when problem situations arise and coordinates with leadership.

• High School Diploma or equivalent required.

• MA or Medical Billing Certificate preferred.

• Minimum 1 year of experience working in a medical billing environment (IPA or HMO preferred), with pre-authorizations and reimbursement regulations on Medi-Cal, CCS, and other government programs required.

• Prior experience working in a clinic/health care specialty call center.

• Prefer experience in utilization management, processing authorization referrals.

AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.