The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable ...
The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable ...
The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable ...
The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable ...
The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable ...
The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable ...
RN Coordinator Utilization Management
Menasha, WI · On-site +1
The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable ...
RN Coordinator Utilization Management
Menasha, WI · On-site +1
The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable ...
The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable ...
The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable ...
The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable ...
The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable ...
The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable ...
The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable ...
WI · On-site
$90 - $120/hr
Job Summary The Manager, Utilization Management (MUM) coordinates the design, development, implementation, and monitoring of the system utilization management functions with the aim to achieve ...
New
WI · On-site
$90 - $120/hr
Job Summary The Manager, Utilization Management (MUM) coordinates the design, development, implementation, and monitoring of the system utilization management functions with the aim to achieve ...
New
WI · On-site
$75 - $105/hr
The Inpatient Utilization Review RN also assists with care coordination and discharge planning activities to support efficient patient progression throughout the continuum of care. Responsibilities ...
WI · On-site
$75 - $105/hr
The Inpatient Utilization Review RN also assists with care coordination and discharge planning activities to support efficient patient progression throughout the continuum of care. Responsibilities ...
The Inpatient Utilization Review RN also assists with care coordination and discharge planning activities to support efficient patient progression throughout the continuum of care. Responsibilities ...
Quick apply
The Inpatient Utilization Review RN also assists with care coordination and discharge planning activities to support efficient patient progression throughout the continuum of care. Responsibilities ...
The Inpatient Utilization Review RN also assists with care coordination and discharge planning activities to support efficient patient progression throughout the continuum of care. Responsibilities ...
Quick apply
The Inpatient Utilization Review RN also assists with care coordination and discharge planning activities to support efficient patient progression throughout the continuum of care. Responsibilities ...
The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain ...
New
The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain ...
New
The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain ...
New
The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain ...
New
RN Patient Navigator, Utilization Review - Full Time
Janesville, WI · On-site
$38.80 - $60.14/hr
OVERVIEW The RN Patient Navigator coordinates and facilitates patient care activities to assure appropriateness of services and efficient utilization of resources, improve coordination of care across ...
New
RN Patient Navigator, Utilization Review - Full Time
Janesville, WI · On-site
$38.80 - $60.14/hr
OVERVIEW The RN Patient Navigator coordinates and facilitates patient care activities to assure appropriateness of services and efficient utilization of resources, improve coordination of care across ...
New
Utilization Management Registered Nurse (RN) - Remote
Kenosha, WI · On-site +1
$70K - $75K/yr
The Utilization Management Registered Nurseis responsible for performing utilization review ... Care Coordination & Quality Support * Initiating referrals of identified patients to disease ...
Utilization Management Registered Nurse (RN) - Remote
Kenosha, WI · On-site +1
$70K - $75K/yr
The Utilization Management Registered Nurseis responsible for performing utilization review ... Care Coordination & Quality Support * Initiating referrals of identified patients to disease ...
The Utilization Management Registered Nurse is responsible for performing utilization review ... Care Coordination & Quality Support * Initiating referrals of identified patients to disease ...
New
Quick apply
The Utilization Management Registered Nurse is responsible for performing utilization review ... Care Coordination & Quality Support * Initiating referrals of identified patients to disease ...
New
Union Position: No Department Details Oversee health plan utilization management department ... Coordinates authorization/certification of care for designated populations to establish medical ...
Union Position: No Department Details Oversee health plan utilization management department ... Coordinates authorization/certification of care for designated populations to establish medical ...
Facilities Coordinator
Oshkosh, WI · On-site
$59 - $72/hr
This position coordinates space inventory and planning systems, analyzes space utilization and facilities data, and provides recommendations to support the efficient use and development of indoor and ...
Facilities Coordinator
Oshkosh, WI · On-site
$59 - $72/hr
This position coordinates space inventory and planning systems, analyzes space utilization and facilities data, and provides recommendations to support the efficient use and development of indoor and ...
Coordinates and facilitates the evaluation of new product requests, product substitutions ... Develops financial analyses, utilization reviews, and cost-benefit assessments to support evidence ...
New
Coordinates and facilitates the evaluation of new product requests, product substitutions ... Develops financial analyses, utilization reviews, and cost-benefit assessments to support evidence ...
New
Senior Equipment Coordinator
Green Bay, WI · On-site
$22/hr
Senior Equipment Coordinator Temporary Part-Time Position Location: 3101 Packerland Dr, Green Bay ... Maximize driver utilization by identifying unused hours. * Make sound equipment utilization ...
Quick apply
Senior Equipment Coordinator
Green Bay, WI · On-site
$22/hr
Senior Equipment Coordinator Temporary Part-Time Position Location: 3101 Packerland Dr, Green Bay ... Maximize driver utilization by identifying unused hours. * Make sound equipment utilization ...
Utilization Coordinator information
See Wisconsin salary details
$15.53 - $19.30
21% of jobs
$19.84 is the 25th percentile. Wages below this are outliers.
$19.30 - $23.07
27% of jobs
The median wage is $23.59 / hr.
$23.07 - $26.84
12% of jobs
$30.20 is the 75th percentile. Wages above this are outliers.
$26.84 - $30.62
17% of jobs
$30.62 - $34.39
14% of jobs
$34.39 - $38.16
5% of jobs
$38.16 - $41.93
0% of jobs
$41.93 - $45.70
0% of jobs
$45.70 - $49.48
1% of jobs
$49.48 - $53.25
2% of jobs
$53.25 - $57.02
1% of jobs
$15
$27
$57
How much do utilization coordinator jobs pay per hour?
As of Sep 5, 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.
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 Wisconsin?
The most popular types of Utilization jobs in Wisconsin are:
What are popular job titles related to Utilization Coordinator jobs in Wisconsin?
For Utilization Coordinator jobs in Wisconsin, the most frequently searched job titles are:
- Medical Review Coordinator
- Utilization Review Physician
- Weekend Physician Advisor Utilization Review
- Remote Utilization Review Social Worker
- Special Education Transition Coordinator
- Non Exempt No Experience Utilization Management Nurse
- Commission Cvs Health Utilization Management
- Utilization Management Coordinator
What job categories do people searching Utilization Coordinator jobs in Wisconsin look for?
The top searched job categories for Utilization Coordinator jobs in Wisconsin are:
- Coordinator Hospital Risk
- Linkage Coordinator
- Authorization Utilization Review Bcba
- Internship Patient Care Coordinator
- Utilization Review Coordinator
- Remote Navihealth Utilization Review
- Prior Authorization Utilization Review
- Autism Coordinator
- Lpn Utilization Review Work From Home
- Bed Placement Coordinator
What cities in Wisconsin are hiring for Utilization Coordinator jobs?
Cities in Wisconsin with the most Utilization Coordinator job openings:
Full-time
Re-posted 2 days ago
Network Health rating
7.9
Based on 5 frontline employees who took The Breakroom Quiz
187th of 315 rated insurance
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
About Network Health
Sourced by ZipRecruiter
Industry
Insurance services
Company size
201 - 500 Employees
Headquarters location
Menasha, WI, US
Year founded
1982