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Inpatient Utilization Management Coordinator Jobs

Uloop Inc.

Utilization Management Coordinator

Miami, FL · On-site

$60 - $80/hr

Utilization Management Coordinator 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 ...

Devoted Health

Utilization Management Coordinator

$21.70 - $27/hr

The Utilization Management Coordinator plays a vital role in supporting Clinical Operations by ... Review member inpatient status and clinical documentation to support episode updates * Ensure ...

UHS

Utilization Management Coordinator

Chicago, IL · On-site

The Utilization Management Coordinato r performs timely, daily clinical reviews with all payer ... Solid understanding of acute inpatient psychiatric hospital operations, including both mental ...

UHS

Utilization Management Coordinator

Chicago, IL · On-site

The Utilization Management Coordinato r performs timely, daily clinical reviews with all payer ... Solid understanding of acute inpatient psychiatric hospital operations, including both mental ...

UHS

Utilization Management Coordinator

Chicago, IL · On-site

$58K - $75K/yr

... our inpatient, partial and outpatient services. The Utilization Management Coordinato r performs ... Serves as liaison to 3rd and 4th party reviewers, effectively coordinating collection of all ...

UHS

Utilization Management Coordinator

Chicago, IL

The Utilization Management Coordinato r performs timely, daily clinical reviews with all payer ... Solid understanding of acute inpatient psychiatric hospital operations, including both mental ...

UHS

Utilization Management Coordinator

Chicago, IL

The Utilization Management Coordinato r performs timely, daily clinical reviews with all payer ... Solid understanding of acute inpatient psychiatric hospital operations, including both mental ...

Saintfrancis

Utilization Management Coordinator

Days Monday-Friday-8am-4:30pm Behavioral health/ inpatient psych/ utilization management experience ... UM Coordinators participate in treatment teams, communicating with providers the details of ...

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How much do inpatient utilization management coordinator jobs pay per hour?

As of Sep 9, 2026, the average hourly pay for inpatient utilization management coordinator in the United States is $29.61, according to ZipRecruiter salary data. Most workers in this role earn between $21.39 and $34.62 per hour, depending on experience, location, and employer.

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Utilization Management RN - Post Acute

Philadelphia, PA • On-site

IntePros
Software Development • 201 - 500 employees
Learn more about InteProsexternal

Other

Posted 15 days ago

Job description

Utilization Management RN
We're actively seeking qualified candidates for a Utilization Management Coordinator / RN opportunity supporting inpatient utilization management and care coordination.
This position is remote; however, candidates must reside in Pennsylvania, New Jersey, or Delaware to be eligible for potential conversion.
Key Requirements
  • Active Pennsylvania RN license required
  • Post-acute care experience required
  • Minimum of 3 years of acute-care clinical experience in a hospital or healthcare setting
  • Utilization management and/or discharge planning experience strongly preferred
  • Experience reviewing medical necessity, level of care, continued stay, and length of stay
  • Experience working with clinical criteria such as InterQual or similar tools preferred
Position Overview
The Utilization Management Coordinator / RN performs utilization management reviews for inpatient hospital admissions and works closely with providers, hospital case management teams, Medical Directors, members, and families to promote high-quality, cost-effective care.
This individual will evaluate medical necessity and continued stay, identify discharge planning needs, and help facilitate transitions to the most appropriate level and setting of care.
Responsibilities
  • Perform telephonic utilization management reviews for inpatient hospital admissions.
  • Evaluate medical necessity, appropriate level of care, continued stay, and length of stay using established clinical criteria.
  • Review treatment plans and collaborate with attending physicians and hospital utilization review teams regarding continued inpatient needs.
  • Identify admissions that no longer meet established criteria and escalate cases to Medical Directors for review.
  • Present relevant clinical information to Medical Directors regarding the member's condition, treatment plan, discharge needs, and potential home or post-acute care requirements.
  • Proactively identify hospitalized members requiring discharge planning support.
  • Collaborate with hospital case managers, physicians, members, and families to facilitate safe and timely transitions to the most appropriate setting.
  • Evaluate potential alternative levels of care and post-acute services when appropriate.
  • Refer members to Case Management and Disease Management programs when additional support is needed.
  • Identify potential quality-of-care concerns, including delays in care, and escalate appropriately.
  • Maintain timely and accurate documentation of utilization review activities and clinical determinations.
  • Ensure utilization decisions comply with applicable state, federal, and accreditation requirements.
  • Develop strong working relationships with providers while delivering a high level of customer service.
  • Identify utilization trends and potential areas for improvement and communicate findings to leadership.
  • Support provider education related to managed care and utilization management processes.
Qualifications
  • Active Pennsylvania Registered Nurse (RN) license required.
  • Minimum of 3 years of acute-care clinical experience in a hospital or healthcare environment.
  • Post-acute care experience required.
  • Previous utilization management, utilization review, concurrent review, case management, and/or discharge planning experience preferred.
  • Strong understanding of medical necessity, level-of-care determination, discharge planning, and transitions of care.
  • Excellent clinical judgment and problem-solving skills.
  • Strong written and verbal communication skills with the ability to effectively collaborate with physicians, providers, and multidisciplinary teams.
  • Highly organized with the ability to manage multiple cases and competing priorities.
  • Strong team-oriented approach and commitment to quality patient care.

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