Medical Assistant-
Remote Utilization Management Coordinator / Medical Assistant Fully Remote- MUST reside within 50 miles of Sacramento
About the Role
The Utilization Management Coordinator / Medical Assistant plays a vital role in supporting high-quality, compliant, and patient-centered care for members by ensuring timely and accurate authorization processing across outpatient, inpatient, and ambulatory services. This is an excellent opportunity for a healthcare professional with medical assisting, referrals, or health plan experience who is looking to grow their career in Utilization Management within a collaborative, mission-driven organization. This fully remote position supports Sacramento-based operations and works closely with providers, health plan partners, and internal UM/QM teams to ensure regulatory compliance, efficient care coordination, and positive provider and member experiences. Key Responsibilities + Coordinate and support authorization processing for outpatient, inpatient, and ambulatory services in accordance with Medicare, IPA, and health plan requirements. + Accurately enter, review, and maintain data within EMR and utilization management systems, ensuring completeness, accuracy, and compliance. + Compile and maintain daily inpatient logs and review designated UM reports to support oversight and operational efficiency. + Process provider referrals, prepare and issue denial and notification letters, and support retro-review coordination as needed. + Provide support for Quality Management (QM) activities, including grievance coordination, QOC activities, and CCS-related processes. + Act as a primary liaison between provider offices and UM/QM staff, ensuring clear communication and timely resolution of questions or issues. + Prepare reports, summaries, and administrative materials for the UM/QM Supervisor, Manager, and Director of Medical Management. + Support departmental audits, compliance initiatives, and documentation standards. + Deliver excellent customer service while maintaining professionalism, confidentiality, and HIPAA compliance. Skills & Competencies + Strong understanding of healthcare workflows, referrals, and authorization processes. + Proficiency with data entry and EMR/UM systems, with exceptional attention to detail. + Ability to manage multiple priorities in a fast-paced, deadline-driven environment. + Clear and professional written and verbal communication skills. + Strong organizational skills and the ability to work independently in a remote setting while staying connected with the team. + Customer-focused mindset with the ability to build positive relationships with providers and internal stakeholders. Qualifications + MUST reside in or around Sacramento area + Minimum 3 years of experience in customer service and referrals within a healthcare setting. + At least 2 years of Medicare health plan experience required. + HMO / IPA experience required. + Background as a Medical Assistant, UM Coordinator, Referral Coordinator, or similar healthcare role strongly preferred. + Experience working with utilization management, referrals, or medical management teams is a plus. Why apply? + Fully remote position with Sacramento-based operations + Exposure to Utilization Management and Quality Management functions + Opportunity to grow within medical management and health plan operations + Collaborative team environment with strong leadership support + Meaningful work that directly impacts patient access, quality, and compliance Job Type & Location This is a Contract to Hire position based out of Sacramento, CA. Pay and Benefits The pay range for this position is $22.00 - $23.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: - Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Mar 25, 2026. Diversity, Equity & Inclusion At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I is embedded into our culture through: + Hiring diverse talent + Maintaining an inclusive environment through persistent self-reflection + Building a culture of care, engagement, and recognition with clear outcomes + Ensuring growth opportunities for our people Actalent is an equal opportunity employer. About Actalent Actalent is a global leader in engineering and sciences services. For more than 40 years, we've helped visionary companies advance their goals. Headquartered in the United States, our teams span 150 offices across North America, EMEA, and APAC-with four delivery centers in India led by 1,000+ extraordinary employees who connect their passion with purpose every day. Our Bangalore, Hyderabad, Pune, and Chennai delivery centers are hubs of engineering expertise, with core capabilities in mechanical and electrical engineering, systems and software, and manufacturing engineering. Our teams deliver work across multiple industries including transportation, consumer and industrial products, and life sciences. We serve more than 4,500 clients, including many Fortune 500 brands. Learn more about how we can work together at actalentservices.com. Apply tot his job Apply To this Job