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Utilization Coordinator Jobs in Raleigh, NC (NOW HIRING)

Belk

Account Coordinator Cosmetics

Raleigh, NC

$19.50 - $25.25/hr

The Account Coordinator manages and coordinates all retail activities relating to their vendor line ... Ensure the utilization of Concierge and clientele development by each Beauty Advisor * Recognize ...

Belk

Account Coordinator Cosmetics

Raleigh, NC

$19.50 - $25.25/hr

The Account Coordinator manages and coordinates all retail activities relating to their vendor line ... Ensure the utilization of Concierge and clientele development by each Beauty Advisor * Recognize ...

Belk

Account Coordinator Cosmetics

Raleigh, NC · On-site

$19.50 - $25.25/hr

The Account Coordinator manages and coordinates all retail activities relating to their vendor line ... Ensure the utilization of Concierge and clientele development by each Beauty Advisor * Recognize ...

WakeMed

Care Coordinator, RN

Cary, NC · On-site

The Care Coordinator will also act as an advocate for the patient, physician and hospital relative to compliance with federal, state and third-party utilization management regulatory requirements.

WakeMed

Care Coordinator, RN

Cary, NC · On-site

The Care Coordinator acts as an advocate and resource for the patient, family, providers and department relative to compliance with federal, state and third party utilization management regulatory ...

DPS Group

Lead BIM Coordinator

Cary, NC · On-site

Utilization of laser scans to ensure coordinated routing and model accuracy against existing conditions. * Read and interpret engineering drawings and specifications. * Coordination of the BIM within ...

Rose Manor Health and Rehab

MDS Coordinator (RN)

Durham, NC · On-site

$33.75 - $40.75/hr

... utilization review meetings • Ensure timely completion, validation, and transmission of all MDS assessments • Collaborate with therapy, nursing, and interdisciplinary team members on ARDs and ...

WakeMed

Care Coordinator, RN

Raleigh, NC · On-site

The Care Coordinator will also act as an advocate for the patient, physician and hospital relative to compliance with federal, state and third party utilization management regulatory requirements.

Lifepoint Health

Office Coordinator

Raleigh, NC · On-site

$15.50 - $20.50/hr

Office Coordinator This position is responsible for supporting the needs of the department with a ... Work with the business office and the utilization review department to ensure payment for services

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All JobsUtilization JobsUtilization Coordinator JobsUtilization Coordinator Jobs in Raleigh, NC

Utilization Coordinator information

See Raleigh, NC salary details

$14

$26

$54

How much do utilization coordinator jobs pay per hour?

As of Jul 20, 2026, the average hourly pay for utilization coordinator in Raleigh, NC is $26.85, according to ZipRecruiter salary data. Most workers in this role earn between $18.94 and $30.38 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 Certified Professional Utilization Review (CPUR), can enhance job prospects and demonstrate expertise in the review process.

What is the highest paying job as a coordinator?

The highest paying coordinator roles are often in specialized fields such as project management, healthcare, or IT, where seniority, certifications, and industry experience significantly impact salary. For example, Program Coordinators or Project Coordinators with advanced certifications like PMP can earn higher salaries, especially in industries with complex or large-scale projects.

What are Utilization Coordinators?

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 jobs make $3,000 a month without a degree?

Utilization Coordinators typically earn between $3,000 and $4,500 per month depending on experience and location, often without requiring a college degree. Other jobs that can pay around $3,000 monthly without a degree include administrative assistants, sales representatives, and certain skilled trades like HVAC technicians or commercial drivers, especially with certifications and experience. These roles often involve on-the-job training or vocational programs rather than formal degrees.

What does a utilization management coordinator do?

A utilization management coordinator reviews and approves healthcare services to ensure they are medically necessary and appropriate, often working with insurance companies and healthcare providers. They analyze patient records, apply clinical guidelines, and use healthcare management tools to facilitate efficient resource use and cost control.
What are the most commonly searched types of Utilization jobs in Raleigh, NC? The most popular types of Utilization jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Utilization Coordinator jobs? Cities near Raleigh, NC with the most Utilization Coordinator job openings:
Utilization Coordinator jobs near you
Infographic showing various Utilization Coordinator job openings in Raleigh, NC as of July 2026, with employment types broken down into 91% Full Time, and 9% Part Time. Highlights an 91% In-person, and 9% Remote job distribution, with an average salary of $55,841 per year, or $26.8 per hour.
Case Manager - Utilization Review

Case Manager - Utilization Review

Granville Health System

Oxford, NC • Hybrid

Full-time

Medical, Dental, Vision, Life, Retirement

Re-posted 2 days ago

Granville Health System rating

8.6

Company rating: 8.6 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

Job description

Case Manager - Utilization Review
Location: Granville Health System, Oxford NC

About Granville Health System:

For over a century, Granville Health System has been at the forefront of quality healthcare. To cater to the evolving needs of its community, Granville Health System has extended its services throughout Granville County, ensuring convenient medical care access for its residents. The Granville Health System main campus can be found at 1010 College Street, Oxford, North Carolina. For more details, visit GHS online at www.ghsHospital.org.

About Oxford, NC

Oxford, NC is a charming and welcoming community that offers a perfect blend of small-town charm and modern convenience, making it an ideal place to live and work. Located just about 30 miles north of Durham and 40 miles from Raleigh. The region enjoys a mild, four-season climate with warm summers, crisp autumns, blooming springs, and gentle winters—perfect for enjoying the area's outdoor activities year-round. With a thriving local economy, excellent healthcare facilities, and a strong sense of community, its historic downtown, scenic parks, and proximity to the Research Triangle ensure a balanced lifestyle with both professional and personal fulfillment.

Position Overview:
The primary role of the Case Manager is to review and monitor members’ utilization of health care services with the goal of maintaining high quality, cost-effective care. This role will provide the medical and utilization review expertise necessary to evaluate patient status.  This includes reviewing clinical information against established criteria, assessing the medical necessity of services and procedures, collaborating with providers and interdisciplinary teams, and ensuring that the patient is placed at the appropriate level of care from the time of admission. This includes providing referral authorization, concurrent review, proactive discharge/transition planning, appropriate referral to case management, and high-dollar claims review.

Position Highlights:

  • Retirement Benefits: NC Local Government Pension Plan (5-year vesting period)
  • Loan Forgiveness: Eligible employer for Public Service Loan Forgiveness (PSLF)
  • Comprehensive Benefits: Medical, dental, vision, life insurance, and various supplemental benefits available

Key Responsibilities:

• Conduct concurrent review of all patients, regardless of payer source, using approved screening criteria

• Perform admission reviews on the first working day following admission

• Conduct continued stay reviews at least every three (3) days or more frequently as indicated

Qualifications

Associate degree in a healthcare-related field or equivalent combination of healthcare experience and education.                                                                    

At least a year of experience in a related role (utilization review, case management, care coordination, insurance authorization/prior authorization, clinical documentation review, hospital patient access or revenue cycle support, healthcare quality or compliance functions).

Strong attention to detail, organizational skills and interpersonal skills.  Ability to interpret clinical documentation and apply review criteria.  Strong communication skills for interaction with physicians and interdisciplinary teams.  Knowledge of healthcare regulations and payer requirements

Preferred

Bachelor’s degree in Health Administration, Public Health, Social Work, Healthcare Management, or related field. Accredited Case Manager (ACM) certification. 

Experience with insurance authorization criteria preferred; one year utilization and discharge planning experience.

Apply Today:
If you're a dedicated professional looking for a position with a focus on work-life balance and the opportunity to make a difference, we encourage you to apply for this position with Granville Health System.

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