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Utilization Coordinator Jobs in Wisconsin (NOW HIRING)

Imedica

Supervisor, Utilization Management

Madison, WI · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Join us in creating a community of connected care, where coordinated, quality service is the norm ... This role oversees utilization management projects, initiates and participates in quality ...

Elevance Health

Family Care-Service Coordinator

Milwaukee, WI · Hybrid

$19.75 - $26/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Family Care-Service Coordinator LTSS Service Coordinator (Case Manager) Hiring near: Milwaukee ... Submits utilization/authorization requests to utilization management with documentation supporting ...

Elevance Health

Family Care-Service Coordinator

Waukesha, WI · Hybrid

$20 - $26.50/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Family Care-Service Coordinator LTSS Service Coordinator (Case Manager) Hiring near: Milwaukee ... Submits utilization/authorization requests to utilization management with documentation supporting ...

Elevance Health

Family Care-Service Coordinator

Waukesha, WI · Hybrid

$20 - $26.50/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

LTSS Service Coordinator (Case Manager) Hiring near: Milwaukee County Field: This field-based role ... Submits utilization/authorization requests to utilization management with documentation supporting ...

Elevance Health

Family Care-Service Coordinator

Milwaukee, WI · Hybrid

$19.75 - $26/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

LTSS Service Coordinator (Case Manager) Hiring near: Milwaukee County Field: This field-based role ... Submits utilization/authorization requests to utilization management with documentation supporting ...

ULINE

Meeting Coordinator

Pleasant Prairie, WI · On-site

$19.75 - $26.25/hr

  • Medical

  • Retirement

  • PTO

Meeting Coordinator Corporate Headquarters 12575 Uline Dr. Pleasant Prairie, WI 53158 Are you ... Prepare reports, including weekly schedules, monthly event metrics and room utilization summaries ...

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All JobsUtilization JobsUtilization Coordinator JobsUtilization Coordinator Jobs in Wisconsin

Utilization Coordinator information

See Wisconsin salary details

$15

$27

$57

How much do utilization coordinator jobs pay per hour?

As of Aug 13, 2026, the average hourly pay for utilization coordinator in Wisconsin is $27.88, according to ZipRecruiter salary data. Most workers in this role earn between $19.66 and $31.54 per hour, depending on experience, location, and employer.

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 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.

What are the most commonly searched types of Utilization jobs in Wisconsin?

The most popular types of Utilization jobs in Wisconsin are:

What cities in Wisconsin are hiring for Utilization Coordinator jobs?

Cities in Wisconsin with the most Utilization Coordinator job openings:

Utilization Coordinator jobs near you
Infographic showing various Utilization Coordinator job openings in Wisconsin as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 18% Part Time, 1% Temporary, and 2% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $57,986 per year, or $27.9 per hour.

RN Coordinator Utilization Management

Network Health

Menasha, WI • On-site

Full-time

Re-posted 8 days ago

Job description

The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable guidelines regarding payment and coverage, and makes determinations for authorization/payment. 

Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required). Travel to the corporate office in Menasha is required occasionally for the position, including on first day. Training is required in person at our Menasha location for the first 6-8 weeks.

Hours: 1.0 FTE, 40 hours per week, 8am - 5pm Monday through Friday

Check out our 2025 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.

Job Responsibilities:

  • Evaluate and process prior authorization requests/referrals submitted from contracted and non-contracted providers
  • Follow Network Health process, policies, and procedures in authorization review of all membership on a pre-service, concurrent and post-service basis. This process includes verifying eligibility and benefits, as well as documenting all utilization management communication
  • Provide education regarding utilization management activities and processes to members, caregivers, providers, and their administrative staff
  • Participate in Utilization Management auditing (i.e. Utilization Management Inter-reviewer reliability and denial files)
  • Refer all members with complex health problems and needs to Network Health Case Management to reduce medical costs while providing a higher quality of life and an ability to take charge of their diseases. This requires an extensive holistic approach to care management assessment
  • Collaborate with other NH departments to develop interdepartmental operational processes
  • Support Utilization Management department programs and goals through active participation
  • Identify and screen candidates for Case Management intervention and determines appropriate level of care from Utilization Management criteria
  • Complete assessments and plans of care including need for medication regime, treatment plans, practitioner follow-up appointments, knowledge of red flags, disease management, Advance Directives, life planning, and self-management of illness to the best of member ability
  • Evaluate cases for cost savings/quality improvement potential
  • Other duties and responsibilities as assigned

Job Requirements:

  • Bachelor of Science in Nursing, preferred
  • Associate Degree in Nursing, required
  • Current registered nurse licensure in Wisconsin required
  • Minimum of four (4) years clinical health care experience as a Registered Nurse (RN) required
  • Experience in insurance, managed care and utilization management preferred

Network Health is an Equal Opportunity Employer

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