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Utilization Coordinator Jobs in Riverside, CA (NOW HIRING)

Dragonfly Recruiting

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Utilization Management Inpatient Coordinator

Orange, CA · Remote

$23 - $26/hr

Utilization Management Coordinator - Inpatient Review (Health Plan) Remote | Contract-to-Permanent Hire | Medicare Advantage We are seeking an experienced Utilization Management Coordinator ...

LSMA Management Inc

Denial Coordinator

San Bernardino, CA · On-site

$26 - $29/hr

The Denial Coordinator ensures compliance, confidentiality, and effective communication while ... Preferred: 1+ years of Utilization Management experience. Any combination of educational and work ...

LSMA Management Inc

Denial Coordinator

San Bernardino, CA · On-site

$26 - $29/hr

JOB SUMMARY The Denial Coordinator serves as a key liaison between patients, providers, health ... Preferred: 1+ years of Utilization Management experience. Any combination of educational and work ...

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All JobsUtilization JobsUtilization Coordinator JobsUtilization Coordinator Jobs in Riverside, CA

Utilization Coordinator information

See Riverside, CA salary details

$16

$28

$58

How much do utilization coordinator jobs pay per hour?

As of Jun 8, 2026, the average hourly pay for utilization coordinator in Riverside, CA is $28.81, according to ZipRecruiter salary data. Most workers in this role earn between $20.34 and $32.60 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 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 are the most commonly searched types of Utilization jobs in Riverside, CA? The most popular types of Utilization jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Utilization Coordinator jobs? Cities near Riverside, CA with the most Utilization Coordinator job openings:
Utilization Coordinator jobs near you
Infographic showing various Utilization Coordinator job openings in Riverside, CA as of May 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $59,934 per year, or $28.8 per hour.
Utilization Management Inpatient Coordinator

Utilization Management Inpatient Coordinator

Dragonfly Recruiting

Orange, CA • Remote

$23 - $26/hr

Full-time

Medical, Dental, PTO

Posted 10 days ago

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Job description

Utilization Management Coordinator – Inpatient Review (Health Plan)

Remote | Contract-to-Permanent Hire | Medicare Advantage

We are seeking an experienced Utilization Management Coordinator – Inpatient Review to support a Health Plan Care Management team. This role supports inpatient, and skilled nursing facility (SNF) utilization review workflows, including census tracking, admissions coordination, medical record collection, transition of care and concurrent review support.

The ideal candidate has health plan experience supporting inpatient review or care management, strong documentation skills, and experience working with referrals, authorizations, and Medicare Advantage populations.

This position is fully remote and offers a contract-to-permanent hire opportunity based on performance and business needs.

Schedule: Monday–Friday, 8:00 AM – 5:00 PM PST
Employment Type: Contract-to-Hire
Location: Remote (must work Pacific Time hours). May reside in any state.

Key Responsibilities

  • Maintain and update daily inpatient and skilled nursing facility census activity.
  • Enter and manage inpatient referrals, authorizations, and member information within health plan systems.
  • Obtain and upload hospital and SNF medical records for concurrent utilization review.
  • Support Utilization Management nurses and case managers by gathering documentation for inpatient concurrent review.
  • Track member admissions, transfers, and discharges and communicate updates to the care management team.
  • Communicate with hospital utilization review departments, case managers, and facility staff regarding documentation and member status.
  • Enter and review ICD-10 and CPT codes related to inpatient referrals and authorizations.
  • Maintain detailed documentation of facility outreach and care coordination activities.
  • Ensure compliance with HIPAA and health plan documentation standards.
  • Assist nurses and case managers with urgent requests and time-sensitive workflows.

Required Qualifications

  • 1–2+ years of Utilization Management Coordinator experience within a Health Plan.
  • Experience supporting inpatient concurrent review or inpatient utilization management workflows.
  • Experience processing referrals, authorizations, or prior authorizations.
  • Experience working with Medicare Advantage members.
  • Basic understanding of medical terminology, ICD-10 codes, CPT codes, and diagnostic coding.
  • Ability to work within multiple health plan systems and provider portals.
  • Strong organizational, documentation, and communication skills.

Preferred Qualifications

  • Experience supporting discharge planning coordination.
  • Familiarity with managed care models (Medicare Advantage, HMO, PPO/MMO).
  • Experience working with hospital admissions departments or utilization review teams.
  • Experience with Epic or provider portals such as Access Express.

Required Skills

  • Microsoft Outlook, Excel, and Word
  • Typing speed of 50+ WPM
  • Strong attention to detail and organizational skills
  • Ability to manage multiple systems and high-volume documentation
  • Strong verbal, written, and phone communication skills

Education

High School Diploma or GED required.

Equal Opportunity Employer

We are an Equal Opportunity Employer and welcome applicants from all backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability, veteran status, age, or any other protected status under applicable law

Company Description

Dragonfly Recruiting was founded with a vision to revolutionize the staffing industry. From our humble beginnings, we have grown into a trusted partner for businesses and job seekers alike. Our journey began with a small team of passionate recruiters who believed in the power of personalized service and the importance of building strong relationships.
Recently, we have expanded our services and our team, always staying true to our core values of integrity, excellence, and commitment to quality. Our growth has been driven by our dedication to understanding the unique needs of our clients and candidates, and our ability to adapt to the ever-changing landscape of the job market.
Dragonfly Recruiting is proud to be a leader in the staffing industry, known for our innovative solutions and our unwavering commitment to helping businesses and individuals achieve their goals.