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Utilization Coordinator Jobs in Puerto Rico (NOW HIRING)

LifeLink

Remote Administrator on Call PR

Guaynabo, PR · On-site +1

  • Medical

  • Dental

  • Life

  • Retirement

  • PTO

Works closely with the Referral Coordinator (RC) in the utilization of available staff and resources with the goal of providing the highest level of support and customer service to referring ...

UHS

PR

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Notify the relevant parties of any coordinated appointments that may be necessary. * Provide backup to Utilization Review Department out of business hours including document in the appropriate ...

UHS

PR · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Notify the relevant parties of any coordinated appointments that may be necessary. * Provide backup to Utilization Review Department out of business hours including document in the appropriate ...

Abbott

Facilities Engineer

Caguas, PR · On-site

  • Medical

  • Life

  • Retirement

Plans and coordinates periodic shutdown to service and maintain equipment, hurricane season ... Lead and support facilities/maintenance projects to maximize efficiency and utilization of ...

Abbott Laboratories

Facilities Engineer

Caguas, PR · On-site

$54K - $109K/yr

  • Medical

  • Life

  • Retirement

Plans and coordinates periodic shutdown to service and maintain equipment, hurricane season ... Lead and support facilities/maintenance projects to maximize efficiency and utilization of ...

CERES

PR

$33 - $38/hr

... coordination of mechanical, electrical, and plumbing trades. This position plays a critical ... Monitor productivity, quality, staffing levels, equipment utilization, and operational performance ...

Mentor Technical Group

Scheduler/Planner

Salinas, PR · On-site

Prepare reports on scheduling performance, compliance with timelines, and resource utilization ... Minimum of 5-10 years' experience in scheduling, production planning, or resource coordination ...

Veterans Health Administration

$89K - $116K/yr

Coordinates with other sections and other services in the area of RT/CAT treatment, treatment scheduling, and delivery of care. * Observes the utilization of recreation therapy treatment modalities ...

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All JobsUtilization JobsUtilization Coordinator JobsUtilization Coordinator Jobs in Puerto Rico

Utilization Coordinator information

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?

AspectUtilization CoordinatorUtilization Review Specialist
CredentialsTypically requires healthcare-related certifications or licenses, such as a Registered Nurse (RN) or healthcare administration backgroundOften requires similar healthcare credentials, including RN, licensed practical nurse (LPN), or medical reviewer certifications
Work EnvironmentWorks in hospitals, clinics, or insurance companies, coordinating patient services and resource allocationWorks mainly in insurance companies or healthcare facilities, reviewing medical necessity and treatment plans
Employer & Industry UsageCommonly employed by healthcare providers and insurance companies to optimize resource usePrimarily 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 popular job titles related to Utilization Coordinator jobs in Puerto Rico?

For Utilization Coordinator jobs in Puerto Rico, the most frequently searched job titles are:

What job categories do people searching Utilization Coordinator jobs in Puerto Rico look for?

The top searched job categories for Utilization Coordinator jobs in Puerto Rico are:

Utilization Coordinator jobs near you
Infographic showing various Utilization Coordinator job openings in Puerto Rico as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 2% Temporary, and 2% Contract. Highlights an 86% Physical, 2% Hybrid, and 12% Remote job distribution.

Program Manager

Criminal Investigation & Law Enforcement | IRS Careers

San Juan, PR • On-site

$125K/yr

Full-time

Posted 14 days ago

Job description

WHAT IS THE LARGE BUSINESS & INTERNATIONAL DIVISION? A description of the business units can be found at: https://www.jobs.irs.gov/about/who/business-divisions
  • Position(s) are to be filled in following area(s):
    • LBI - Strategic Programs

REVIEW THE ADDITIONAL INFORMATION BELOW FOR FURTHER DETAILSQualifications:

Federal experience is not required. Experience may have been gained in the public sector, private sector or through Volunteer Service. One year of experience refers to full-time work; part-timework is considered on a prorated basis. To ensure full credit for your work experience, please indicate dates of employment by month/day/year, and indicate number of hours worked per week, on your resume.
SPECIALIZED EXPERIENCE IR-1: To be minimally qualified for this position you must have at least one (1) year of specialized experience equivalent to the next lower-level payband or GS grade in the normal line of progression.
Specialized experience would include one year of substantive supervisory or program management experience at the GS-13 or GS-14 level or equivalent level manager or comparable management or leadership experiences outside of Federal service.
To be qualifying for this position your experience should be sufficient to demonstrate:

  • Experience leading strategic planning initiatives by evaluating legislative proposals, organizational priorities, policy changes, and emerging program issues; developing implementation strategies and long-range plans that support organizational objectives and mission requirements.
  • Experience analyzing program operations, organizational performance, workload data, resource utilization, operational risks, and program outcomes; identifying issues and developing recommendations that improve operational effectiveness, efficiency, and program performance.
  • Experience developing performance measures, evaluation criteria, and accountability processes used to monitor program accomplishments, assess organizational performance, evaluate results, and recommend operational improvements.
  • Experience preparing executive reports, briefing materials, written documentation, analytical studies, and recommendations that communicate complex findings, support organizational planning, and facilitate management decision-making.
  • Experience planning, coordinating, monitoring, and evaluating multiple projects or organizational initiatives involving competing priorities, changing requirements, resource constraints, and cross-functional stakeholders to achieve strategic program objectives.
  • Experience conducting operational research by evaluating program data, identifying organizational trends, assessing the impact of proposed changes, and developing evidence-based recommendations that improve program operations, policy implementation, or organizational performance.
  • Experience interpreting Federal tax laws, regulations, Internal Revenue Service program requirements, compliance guidance, and related policies to evaluate program impacts, resolve technical issues, develop recommendations, and support implementation of organizational initiatives.
  • Experience evaluating financial information, budget data, staffing requirements, workload trends, and resource utilization to develop recommendations that support strategic planning, operational priorities, and effective allocation of organizational resources.

AND

You must also meet the following requirement(s):
  • TIME AFTER COMPETITIVE APPOINTMENT (TACA): By the closing date (or if this is an open continuous announcement, by the cut-off date) specified in this job announcement, current civilian employees must have completed at least 90 days of federal civilian service since their latest non-temporary appointment from a competitive referral certificate, known as time after competitive appointment. For this requirement, a competitive appointment is one where you applied to and were appointed from an announcement open to "All US Citizens".

For more information on qualifications please refer to OPM's Qualifications Standards.
Go to Understanding the IRS Paybands for GS/IR conversion.

Education:A college or university degree generally must be from an accredited (or pre-accredited) college or university recognized by the U.S. Department of Education. For a list of schools which meet these criteria, please refer to Department of Education Accreditation page.
FOREIGN EDUCATION: Education completed in foreign colleges or universities may be used to meet the requirements. You must show proof the education credentials have been deemed to be at least equivalent to that gained in conventional U.S. education program. It is your responsibility to provide such evidence when applying. Click here (Section 3, Explanation of Terms) or here for Foreign Education Credentialing instructions.
We recommend choosing an evaluator from a member organization of one of the following national associations of credential evaluation services: National Association of Credential Evaluation Services (NACES) or Association of International Credentials Evaluators (AICE).Employment Type: OTHER

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