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Utilization Management Assistant Jobs in Florida

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Utilization Management Assistant information

See Florida salary details

$21.7K

$36.2K

$51.9K

How much do utilization management assistant jobs pay per year?

As of Jul 14, 2026, the average yearly pay for utilization management assistant in Florida is $36,166.00, according to ZipRecruiter salary data. Most workers in this role earn between $31,400.00 and $36,200.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Utilization Management Assistant, and why are they important?

To thrive as a Utilization Management Assistant, you need a solid understanding of healthcare processes, medical terminology, and administrative procedures, often supported by a high school diploma or associate's degree. Familiarity with electronic health records (EHR) systems, insurance verification tools, and Microsoft Office Suite is typically required. Strong organizational skills, attention to detail, and effective communication are crucial soft skills for managing documentation and collaborating with clinical teams. These skills ensure accurate data handling, efficient workflow, and compliance with healthcare regulations, all of which are vital for successful utilization management operations.

What are some common challenges Utilization Management Assistants face when working with insurance pre-authorizations?

Utilization Management Assistants often encounter challenges such as navigating complex insurance requirements, meeting tight deadlines for pre-authorization requests, and communicating effectively with both healthcare providers and insurance representatives. Staying organized and detail-oriented is essential to ensure all documentation is accurate and submitted promptly. Additionally, adapting to frequent changes in insurance policies and maintaining strong problem-solving skills are key to overcoming these obstacles.

What is a Utilization Management Assistant?

A Utilization Management Assistant is a healthcare administrative professional who supports the utilization management team by handling clerical tasks, coordinating communications, and organizing patient documentation. They often help ensure that medical services are used efficiently and that insurance requirements are met by gathering information, processing authorizations, and maintaining records. This role is essential in facilitating collaboration between healthcare providers, insurance companies, and patients, ultimately helping to optimize the quality and cost-effectiveness of patient care.
What are the most commonly searched types of Utilization Management jobs in Florida? The most popular types of Utilization Management jobs in Florida are:
What cities in Florida are hiring for Utilization Management Assistant jobs? Cities in Florida with the most Utilization Management Assistant job openings:
Utilization Management Assistant jobs near you
Utilization Management Coordinator

Utilization Management Coordinator

Independent Living Systems

Miami, FL • On-site

Full-time

Posted 28 days ago

Independent Living Systems rating

6.5

Company rating: 6.5 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

Job description

We are seeking a Utilization Management Coordinator to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.

About the Role:

The Utilization Management Coordinator plays an essential role in ensuring that the authorization requests are processed effectively. The Utilization Management Coordinator reviews the prior authorization form received for documentation completeness and determines if the requested service requires an authorization. This role includes inbound and outbound communication with both internal and external customers. Ultimately, the Utilization Management Coordinator contributes to improving member outcomes by facilitating timely access to necessary care.

Minimum Qualifications:

  • High school diploma or equivalent required
  • 2 years of experience as a medical office referral/authorization clerk, office assistant or other medical office experience.
  • Strong knowledge of healthcare regulations, and medical terminology.
  • Relevant experience may substitute for the educational requirement on a year-for-year basis.

Preferred Qualifications:

  • Associate degree in Health Administration, or a related healthcare field
  • Certification in Utilization Review (e.g., Certified Professional in Utilization Review - CPUR) or Case Management (e.g., CCM).
  • Experience working within managed care organizations or health insurance companies.
  • Familiarity with regulatory requirements such as Florida Medicaid/SMMC and CMS guidelines, HIPAA and current health plan accreditation standards,.

Responsibilities:

  • Demonstrate commitment to Our Mission and models ILS Experience Standards of Excellence.
  • Continuously reviews prior authorization requests received via oral, provider portal, fax and/or email to ensure timely processing.
  • Screens prior authorization requests for appropriate referral to the Clinical Care Specialist.
  • Performs non-medical research including eligibility verification, reviewing the prior authorization grid to confirm if services do or do not require prior authorization.
  • Places outbound calls to providers to request clinical information for review.
  • Perform other duties as assigned.

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