Part-Time Utilization Review Coordinator, Pre Adm - Hybrid
UPMC
1 day ago
Part-time
Remote friendly (Pittsburgh, Pennsylvania, United States)
Worldwide
Registered Nurse
Utilization Review Coordinator (RN) - Outpatient Kidney Transplant UPMC Presbyterian | Oakland, PA
Make a Lasting Impact on the Lives of Transplant Patients Are you an experienced Registered Nurse with a background in managed care, utilization review, care coordination, or insurance authorization? Do you want to use your clinical expertise to help transplant patients access the care they need?
UPMC Presbyterian's nationally recognized Outpatient Kidney Transplant Division is seeking a Utilization Review Coordinator (RN) to join our dedicated team. In this role, you'll collaborate with healthcare providers, insurance companies, and transplant professionals to help ensure patients receive timely approvals for critical treatments, procedures, medications, and hospital services.
If you're passionate about patient advocacy, enjoy problem-solving, and want a meaningful role with excellent work-life balance, we'd love to hear from you!
Why Join Our Team? ✅ Flexible daytime schedule
✅ No weekends, holidays, or on-call responsibilities
✅ Hybrid work opportunity
✅ Meaningful work supporting transplant patients throughout their care journey
✅ Collaborative and mission-driven transplant team
Schedule & Work Arrangement Part-time position requiring a minimum of 20 hours per week
Flexible work schedule between 8:00 AM and 4:30 PM, Monday through Friday
Primarily remote work environment
One required on-site check-in each month at our Oakland location
What You'll Do Serve as a liaison between physician offices and insurance providers to secure authorization and reimbursement for medications, treatments, procedures, and hospital admissions.
Obtain and communicate treatment plans, diagnoses, and supporting clinical documentation to insurance carriers and regulatory agencies.
Support transplant coordinators and clinical staff by facilitating the authorization process and helping remove barriers to patient care.
Provide guidance regarding payer-specific requirements, regulations, and reimbursement processes.
Maintain accurate authorization records and ensure compliance with HIPAA and applicable regulatory standards.
Collaborate with interdisciplinary teams to support positive patient outcomes.
Participate in professional development and continuing education opportunities.
Demonstrate UPMC's commitment to exceptional patient and customer service.
Help Transplant Patients Receive the Care They Need Join a team where your clinical knowledge and advocacy make a direct difference in patient outcomes. Apply today and become part of UPMC Presbyterian's commitment to life-changing
Registered Nurse (RN)
Diploma or Associate Degree in Nursing
Minimum of 2 years of recent clinical nursing experience
Strong organizational and time-management skills
Excellent verbal and written communication skills
Ability to manage multiple priorities while maintaining attention to detail
Ability to analyze, interpret, and communicate information relevant to the authorization process
Preferred Utilization review or pre-authorization experience
Managed care experience
Transplant experience
Knowledge of third-party payer regulations and reimbursement practices
Understanding of treatment needs within the transplant patient population
Licensure & Clearances Current Registered Nurse (RN) license
Act 34 Criminal Clearance
Make a Lasting Impact on the Lives of Transplant Patients Are you an experienced Registered Nurse with a background in managed care, utilization review, care coordination, or insurance authorization? Do you want to use your clinical expertise to help transplant patients access the care they need?
UPMC Presbyterian's nationally recognized Outpatient Kidney Transplant Division is seeking a Utilization Review Coordinator (RN) to join our dedicated team. In this role, you'll collaborate with healthcare providers, insurance companies, and transplant professionals to help ensure patients receive timely approvals for critical treatments, procedures, medications, and hospital services.
If you're passionate about patient advocacy, enjoy problem-solving, and want a meaningful role with excellent work-life balance, we'd love to hear from you!
Why Join Our Team? ✅ Flexible daytime schedule
✅ No weekends, holidays, or on-call responsibilities
✅ Hybrid work opportunity
✅ Meaningful work supporting transplant patients throughout their care journey
✅ Collaborative and mission-driven transplant team
Schedule & Work Arrangement Part-time position requiring a minimum of 20 hours per week
Flexible work schedule between 8:00 AM and 4:30 PM, Monday through Friday
Primarily remote work environment
One required on-site check-in each month at our Oakland location
What You'll Do Serve as a liaison between physician offices and insurance providers to secure authorization and reimbursement for medications, treatments, procedures, and hospital admissions.
Obtain and communicate treatment plans, diagnoses, and supporting clinical documentation to insurance carriers and regulatory agencies.
Support transplant coordinators and clinical staff by facilitating the authorization process and helping remove barriers to patient care.
Provide guidance regarding payer-specific requirements, regulations, and reimbursement processes.
Maintain accurate authorization records and ensure compliance with HIPAA and applicable regulatory standards.
Collaborate with interdisciplinary teams to support positive patient outcomes.
Participate in professional development and continuing education opportunities.
Demonstrate UPMC's commitment to exceptional patient and customer service.
Help Transplant Patients Receive the Care They Need Join a team where your clinical knowledge and advocacy make a direct difference in patient outcomes. Apply today and become part of UPMC Presbyterian's commitment to life-changing
Registered Nurse (RN)
Diploma or Associate Degree in Nursing
Minimum of 2 years of recent clinical nursing experience
Strong organizational and time-management skills
Excellent verbal and written communication skills
Ability to manage multiple priorities while maintaining attention to detail
Ability to analyze, interpret, and communicate information relevant to the authorization process
Preferred Utilization review or pre-authorization experience
Managed care experience
Transplant experience
Knowledge of third-party payer regulations and reimbursement practices
Understanding of treatment needs within the transplant patient population
Licensure & Clearances Current Registered Nurse (RN) license
Act 34 Criminal Clearance