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Utilization Coordinator Jobs (NOW HIRING)

Wellington Regional Medical Center

UM COORDINATOR

Madera, CA · On-site

$50 - $55/hr

... coordination of patient care, daily clinical reviews, quality documentation, appeals, and reporting ... Contributes to monthly utilization data trends using hospital data tools to report for the overall ...

UHS

UM COORDINATOR

Madera, CA · On-site

$50 - $55/hr

... coordination of patient care, daily clinical reviews, quality documentation, appeals, and reporting ... Contributes to monthly utilization data trends using hospital data tools to report for the overall ...

UHS

UM Coordinator - Full-time days

Memphis, TN

Oversees utilization review activities with other departments to ensure reimbursement for services provided by the hospital. The UM Coordinator facilitates physician weekly staffing meetings and ...

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How much do utilization coordinator jobs pay per hour?

As of Jun 6, 2026, the average hourly pay for utilization coordinator in the United States is $27.62, according to ZipRecruiter salary data. Most workers in this role earn between $19.47 and $31.25 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.
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What states have the most Utilization Coordinator jobs? States with the most job openings for Utilization Coordinator jobs include:
Utilization Coordinator jobs near you
Infographic showing various Utilization Coordinator job openings in the United States as of May 2026, with employment types broken down into 1% As Needed, 90% Full Time, 8% Part Time, and 1% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $57,448 per year, or $27.6 per hour.
UTILIZATION MANAGEMENT COORDINATOR I MSO

UTILIZATION MANAGEMENT COORDINATOR I MSO

NORTH EAST MEDICAL SERVICES

Burlingame, CA

$38/hr

Other

Medical, Dental, Vision, Retirement

Posted yesterday

Job description

The Utilization Management Coordinator I functions under the direct supervision of a physician or Registered Nurse, performing utilization management (UM) and care coordination duties for the NEMS MSO.

ESSENTIAL JOB FUNCTIONS:

  • Review daily all incoming Referral Requests and Treatment Authorization Requests for inpatient and outpatient services.
  • Process and approve authorization requests according to the NEMS MSO Authorization Grid and to established clinical guidelines.
  • Must meet the quantitative productivity standard of 250 authorizations per week for the outpatient UM Coordinator and 115 authorizations per week for the inpatient UM Coordinator.
  • For complex cases, research additional relevant clinical guidelines from different sources.
  • Responsible to prepare and present complex cases to Medical Director for review; confirm Medical Director's approval/modification/denial decision for record tracking.
  • Perform Care Coordination activities with members, families, specialists, and ancillary providers for authorized services.
  • Perform customer service for UM inquiries to Primary Care Physician, specialist, and members.
  • Stay current with DHCS regulations, Health Plan agreements, and Industry Standard guidelines applicable to healthcare programs.
  • Communicate UM related information and updates to all members of the health care team, patients, and their families.
  • Follow the appropriate turnaround timeframe for decisions and notification of members and providers.
  • Performs other job duties as required by manager/supervisor.
  • Completion of a 2-year degree or higher.
  • Knowledge of medical terminology.
  • Completion of a recognized Medical Assistant degree or certificate a plus.
  • Excellent data entry skills.
  • Working knowledge of managed-care a plus.
  • Strong communication, analytical, and problem-solving skills.
  • Knowledge of community resources and cultural needs.
  • Good organization and prioritization skills, outstanding in time management.
  • Recent experience in a clinic or outpatient setting desirable; able to perform efficiently and appropriately in a busy environment.

LANGUAGE:

  • Must be able to fluently speak, read and write English.
  • Fluent in Chinese (Cantonese and/or Mandarin) preferred.
  • Fluent in other languages is an asset.

STATUS:

  • This is an FLSA Non-exempt position.
  • This is not an OSHA high-risk position.
  • This is a Full Time position.

NEMS is proud to be an Equal Opportunity Employer welcoming diversity in our workforce. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

NEMS BENEFITS: Competitive benefits, including free medical, dental and vision insurance for employee, spouse and/or children; and company contribution to 401(k).
 

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