Responsibilities include using effective relationship management, coordination of services ... such as over or under-utilization of services, potential up-coding, over billing, etc.
Responsibilities include using effective relationship management, coordination of services ... such as over or under-utilization of services, potential up-coding, over billing, etc.
Responsibilities include using effective relationship management, coordination of services ... such as over or under-utilization of services, potential up-coding, over billing, etc.
Responsibilities include using effective relationship management, coordination of services ... such as over or under-utilization of services, potential up-coding, over billing, etc.
Clinical Care Coordinator
$83K - $124K/yr
The role integrates utilization management, discharge planning, interdisciplinary collaboration, payer communication, patient advocacy, regulatory compliance, and transition-of-care coordination to ...
Clinical Care Coordinator
$83K - $124K/yr
The role integrates utilization management, discharge planning, interdisciplinary collaboration, payer communication, patient advocacy, regulatory compliance, and transition-of-care coordination to ...
Clinical Care Coordinator
Honolulu, HI · On-site
$83K - $124K/yr
The role integrates utilization management, discharge planning, interdisciplinary collaboration, payer communication, patient advocacy, regulatory compliance, and transition-of-care coordination to ...
Clinical Care Coordinator
Honolulu, HI · On-site
$83K - $124K/yr
The role integrates utilization management, discharge planning, interdisciplinary collaboration, payer communication, patient advocacy, regulatory compliance, and transition-of-care coordination to ...
Responsibilities include using effective relationship management, coordination of services ... such as over or under-utilization of services, potential up-coding, over billing, etc.
Responsibilities include using effective relationship management, coordination of services ... such as over or under-utilization of services, potential up-coding, over billing, etc.
Responsibilities include using effective relationship management, coordination of services ... under-utilization of services, potential up-coding, over billing, etc. Communicates timely ...
Responsibilities include using effective relationship management, coordination of services ... under-utilization of services, potential up-coding, over billing, etc. Communicates timely ...
Responsibilities include using effective relationship management, coordination of services ... such as over or under-utilization of services, potential up-coding, over billing, etc.
Responsibilities include using effective relationship management, coordination of services ... such as over or under-utilization of services, potential up-coding, over billing, etc.
Responsibilities include using effective relationship management, coordination of services ... such as over or under-utilization of services, potential up-coding, over billing, etc.
Responsibilities include using effective relationship management, coordination of services ... such as over or under-utilization of services, potential up-coding, over billing, etc.
Responsibilities include using effective relationship management, coordination of services ... such as over or under-utilization of services, potential up-coding, over billing, etc.
Responsibilities include using effective relationship management, coordination of services ... such as over or under-utilization of services, potential up-coding, over billing, etc.
Responsibilities include using effective relationship management, coordination of services ... such as over or under-utilization of services, potential up-coding, over billing, etc.
Responsibilities include using effective relationship management, coordination of services ... such as over or under-utilization of services, potential up-coding, over billing, etc.
Responsibilities include using effective relationship management, coordination of services ... under-utilization of services, potential up-coding, over billing, etc. Communicates timely ...
Responsibilities include using effective relationship management, coordination of services ... under-utilization of services, potential up-coding, over billing, etc. Communicates timely ...
Responsibilities include using effective relationship management, coordination of services ... such as over or under-utilization of services, potential up-coding, over billing, etc.
Responsibilities include using effective relationship management, coordination of services ... such as over or under-utilization of services, potential up-coding, over billing, etc.
Develop and/or assist in the creation of various tools to support Utilization Management activities ... Analyzes business problems and issues; coordinates input from various departments, units and/or ...
Develop and/or assist in the creation of various tools to support Utilization Management activities ... Analyzes business problems and issues; coordinates input from various departments, units and/or ...
The coordinator will assist the health plan in identifying members who may be eligible for and in ... Ensure optimal utilization and management of existing funding such as DHS/HUD Homeless, Non-elderly ...
The coordinator will assist the health plan in identifying members who may be eligible for and in ... Ensure optimal utilization and management of existing funding such as DHS/HUD Homeless, Non-elderly ...
The coordinator will assist the health plan in identifying members who may be eligible for and in ... Ensure optimal utilization and management of existing funding such as DHS/HUD Homeless, Non-elderly ...
The coordinator will assist the health plan in identifying members who may be eligible for and in ... Ensure optimal utilization and management of existing funding such as DHS/HUD Homeless, Non-elderly ...
Housing Coordinator
Honolulu, HI · On-site
$50K - $65K/yr
The coordinator will assist the health plan in identifying members who may be eligible for and in ... Ensure optimal utilization and management of existing funding such as DHS/HUD Homeless, Non-elderly ...
Housing Coordinator
Honolulu, HI · On-site
$50K - $65K/yr
The coordinator will assist the health plan in identifying members who may be eligible for and in ... Ensure optimal utilization and management of existing funding such as DHS/HUD Homeless, Non-elderly ...
The coordinator will assist the health plan in identifying members who may be eligible for and in ... Ensure optimal utilization and management of existing funding such as DHS/HUD Homeless, Non-elderly ...
The coordinator will assist the health plan in identifying members who may be eligible for and in ... Ensure optimal utilization and management of existing funding such as DHS/HUD Homeless, Non-elderly ...
Senior Freight Coordinator, Sea with Security Clearance
Aiea, HI · On-site
$17.75 - $23.50/hr
Validate the accuracy of daily maritime movement situation reports and vessel utilization metrics to mitigate theater logistics gaps. * Manage the daily coordination of port-of-debarkation (POD ...
Senior Freight Coordinator, Sea with Security Clearance
Aiea, HI · On-site
$17.75 - $23.50/hr
Validate the accuracy of daily maritime movement situation reports and vessel utilization metrics to mitigate theater logistics gaps. * Manage the daily coordination of port-of-debarkation (POD ...
Care Coordinator
Kapolei, HI · On-site
$20.48/hr
Care Coordinator Healthcare - Other Care Coordinator - HI ARNG Kapolei, HI Qualifications: Medical ... Utilization review or disease management experience or certification in case management is ...
Care Coordinator
Kapolei, HI · On-site
$20.48/hr
Care Coordinator Healthcare - Other Care Coordinator - HI ARNG Kapolei, HI Qualifications: Medical ... Utilization review or disease management experience or certification in case management is ...
Care Coordinator
Honolulu, HI · On-site
$16.50 - $22/hr
The Care Coordinator supports care management activities and the teams assigned to members to ... utilization (UM) reports, BH reports, member service reports, HEDIS, QI reports, and claims ...
Care Coordinator
Honolulu, HI · On-site
$16.50 - $22/hr
The Care Coordinator supports care management activities and the teams assigned to members to ... utilization (UM) reports, BH reports, member service reports, HEDIS, QI reports, and claims ...
Utilization Coordinator information
See Hawaii salary details
$15.98 - $19.87
21% of jobs
$20.43 is the 25th percentile. Wages below this are outliers.
$19.87 - $23.75
27% of jobs
The median wage is $24.28 / hr.
$23.75 - $27.63
12% of jobs
$31.09 is the 75th percentile. Wages above this are outliers.
$27.63 - $31.51
17% of jobs
$31.51 - $35.40
14% of jobs
$35.40 - $39.28
5% of jobs
$39.28 - $43.16
0% of jobs
$43.16 - $47.04
0% of jobs
$47.04 - $50.93
1% of jobs
$50.93 - $54.81
2% of jobs
$54.81 - $58.69
1% of jobs
$15
$28
$58
How much do utilization coordinator jobs pay per hour?
As of Aug 26, 2026, the average hourly pay for utilization coordinator in Hawaii is $28.70, according to ZipRecruiter salary data. Most workers in this role earn between $20.24 and $32.45 per hour, depending on experience, location, and employer.
What is a utilization coordinator?
Utilization Coordinators are healthcare professionals responsible for reviewing and monitoring the use of medical services to ensure patients receive appropriate care efficiently and cost-effectively. They assess treatment plans, review medical records, and help coordinate care among providers to ensure compliance with insurance and regulatory guidelines. Utilization Coordinators also work with clinical staff to determine the medical necessity of procedures and help optimize patient outcomes while managing healthcare costs.
How does a utilization coordinator typically interact with clinical and administrative teams in a healthcare setting?
A Utilization Coordinator regularly collaborates with both clinical teams, such as physicians and nurses, and administrative staff to ensure that patient care services are medically necessary and efficiently delivered. They review medical records, coordinate pre-authorizations, and communicate with insurance providers to support appropriate resource use. Effective communication and teamwork are essential, as Utilization Coordinators often serve as a liaison between departments, helping to resolve discrepancies and streamline processes for optimal patient outcomes.
What are the key skills and qualifications needed to thrive as a utilization coordinator, and why are they important?
To thrive as a Utilization Coordinator, you need a background in healthcare or social services, strong analytical skills, and familiarity with medical terminology, often supported by a relevant degree or certification. Proficiency in case management software, electronic health records (EHRs), and knowledge of insurance policies and regulatory requirements is typically required. Excellent communication, organizational, and problem-solving abilities help you effectively coordinate care and advocate for patient needs. These skills ensure efficient resource utilization, regulatory compliance, and optimal patient outcomes within healthcare organizations.
What is the difference between Utilization Coordinator vs Utilization Review Specialist?
| Aspect | Utilization Coordinator | Utilization Review Specialist |
|---|---|---|
| Credentials | Typically requires healthcare-related certifications or licenses, such as a Registered Nurse (RN) or healthcare administration background | Often requires similar healthcare credentials, including RN, licensed practical nurse (LPN), or medical reviewer certifications |
| Work Environment | Works in hospitals, clinics, or insurance companies, coordinating patient services and resource allocation | Works mainly in insurance companies or healthcare facilities, reviewing medical necessity and treatment plans |
| Employer & Industry Usage | Commonly employed by healthcare providers and insurance companies to optimize resource use | Primarily employed by insurance companies and third-party payers for case reviews |
While both roles involve healthcare coordination and require similar credentials, the Utilization Coordinator focuses on managing patient services and resource allocation, whereas the Utilization Review Specialist primarily reviews medical necessity and treatment plans for approval or denial.
What degree do I need for utilization review?
Utilization coordinators typically need at least a bachelor's degree in healthcare administration, nursing, or a related field. Relevant certifications, such as the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects. Strong knowledge of medical terminology, insurance processes, and data management tools is also important.
What are the most commonly searched types of Utilization jobs in Hawaii?
The most popular types of Utilization jobs in Hawaii are:
What are popular job titles related to Utilization Coordinator jobs in Hawaii?
For Utilization Coordinator jobs in Hawaii, the most frequently searched job titles are:
What job categories do people searching Utilization Coordinator jobs in Hawaii look for?
The top searched job categories for Utilization Coordinator jobs in Hawaii are:
What cities in Hawaii are hiring for Utilization Coordinator jobs?
Cities in Hawaii with the most Utilization Coordinator job openings:
Other
Posted 25 days ago
Job description
- Applies appropriate medical necessity criteria from established medical policies and clinical practice guidelines to apply concurrent review determinations as described in the Medical Management UM work plan.
- This detailed clinical judgment includes determination of inpatient hospital stays as medically appropriate for the member's clinical condition or whether the stay requires referral to a Medical Director for potential denial.
- The Nurse Reviewer must follow each line of business requirements and each accrediting body's (CMS, NCQA, HSAG) requirements for each inpatient admission.
- Responsibilities include using effective relationship management, coordination of services, resource management, education, patient advocacy, and related interventions to:
- Promote improved quality of care and/or life
- Promote cost effective medical outcomes
- Prevent hospitalization when possible and appropriate
- Promote decreased lengths of hospital stays when appropriate
- Ensure the quality-of-care member is receiving during hospital stay is appropriate
- Ensure appropriate levels of care are received by patients
- Consult with Medical Directors on potential quality issues encountered during review of medical records in situations when the complexity of the member's medical, surgical and/or pharmaceutical management is unclear and may require further review or intervention and follow up with attending physicians, hospitalists, or other facility staff
- Provide appropriate consultation and referral to Case Management or QUEST Integration program as appropriate
- Identify appropriate alternative and non-traditional resources and demonstrate creativity in managing each case to fully utilize all available inpatient and community resources.
- Identifies cost savings and accurately records all communications and interventions.
- Evaluates suspended claims against medical records to determine the medical necessity and appropriateness of medical services, identify irregularities such as over or under-utilization of services, potential up-coding, over billing, etc.
- Communicates timely, accurate information either verbally or in writing using clinical judgment, knowledge of medical/reimbursement policies and plan benefits to internal MM staff, other internal departments (Claims Administration, Customer Relations, etc.), providers, members, and other authorized persons.
- For denied services, ensures the denial, benefit and appeal language are accurate and consistent with department procedures, accreditation, and regulatory guidelines.
- Identifies and refers members with specific medical and/or behavioral health needs or complex case management and collaborates with case management staff as needed. Also identifies and refers quality of care issues and suspected fraud, waste, or abuse to the appropriate departments.
- Performs all other miscellaneous responsibilities and duties as assigned or directed.
#LI-Hybrid
About HMSA
Sourced by ZipRecruiter
Industry
Insurance services
Company size
1,001 - 5,000 Employees
Headquarters location
Honolulu, HI, US