theoncologyinstitute

UM Authorization Analyst 2 Bilingual

Tampa, Florida, United States

Sponsorship not specified$71k-$85kDetected 30 days ago

Customer SupportEHR/EMRClinical TrialsCommunicationOrganizational Skills

About the role

With over 180 employed and affiliate clinicians and over 100 clinics and affiliate locations of care across five states and growing, TOI is changing oncology for the better.
Join a team where your clinical insight directly shapes patient outcomes and care quality.
JOB PURPOSE AND SUMMARY: The UM Authorization Analyst II is responsible for ensuring the timely and accurate processing of medical procedure authorizations.

As a UM Authorization Analyst II, you'll play a critical role in ensuring timely, evidence-based decisions that support both patients and providers-while working in a collaborative environment that values accuracy, efficiency, and professional growth.
Creating, reviewing, and administering corrective action forms with support and guidance from the Director, Utilization Management Compliance.
Performing other duties as assigned to support operational goals.

The physical demands described above are representative of those that must be met by an employee to successfully perform the essential functions of this job.
4-6 years of experience in utilization management.
Bilingual in English and Spanish required.

Excellent communication and interpersonal skills.
In-depth knowledge of medical procedure authorization processes and healthcare insurance requirements.
Ability to analyze data and implement process improvements.
Proficiency with medical billing software and electronic health records (EHR) systems.
Strong organizational skills and attention to detail.
Strong understanding of evidence-based guidelines (MCG, National Coverage Determinations, Local Coverage Determinations).
Understanding of prior authorization regulatory requirements and turnaround time expectations (CMS, AHCA, NCQA, URAC).

Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role.

Identifying and forwarding standard or expedited appeals to the appropriate health plan.
The UM Authorization Analyst II is responsible for ensuring the timely and accurate processing of medical procedure authorizations.
This role includes reviewing authorization requests, maintaining compliance with regulations, and coordinating with healthcare providers and insurance companies to support patient care.

This listing is sourced directly from theoncologyinstitute's careers page and normalized into a canonical job model.