... of Care cases across all lines of business (Commercial and Medicare). · Independently coordinates ... · MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. · MUST HAVE UM experience ...
... of Care cases across all lines of business (Commercial and Medicare). · Independently coordinates ... · MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. · MUST HAVE UM experience ...
Care Transition Nurse
Providence, RI · Remote
$50/hr
... Coordination & Case Management, Population Health & Value-Based Care, and Managed Care & Utilization Management. Benefits Full-time or part-time remote position Choose which projects you want to work ...
Care Transition Nurse
Providence, RI · Remote
$50/hr
... Coordination & Case Management, Population Health & Value-Based Care, and Managed Care & Utilization Management. Benefits Full-time or part-time remote position Choose which projects you want to work ...
Reports to the Director of Care Management or designee. Conducts surveillance over medical ... Acts as a liaison with the Care Coordination Manager to discuss approaching discharge readiness of ...
Reports to the Director of Care Management or designee. Conducts surveillance over medical ... Acts as a liaison with the Care Coordination Manager to discuss approaching discharge readiness of ...
SUMMARY Reports to the Director of Care Management or designee. Conducts surveillance over medical ... Acts as a liaison with the Care Coordination Manager to discuss approaching discharge readiness of ...
SUMMARY Reports to the Director of Care Management or designee. Conducts surveillance over medical ... Acts as a liaison with the Care Coordination Manager to discuss approaching discharge readiness of ...
Care Coordinator
$23 - $25/hr
Time Management: You are a conscious planner and a thoughtful decision maker who adheres to ... We are seeking an experienced Care Coordinator who will be responsible for actively engaging and ...
Care Coordinator
$23 - $25/hr
Time Management: You are a conscious planner and a thoughtful decision maker who adheres to ... We are seeking an experienced Care Coordinator who will be responsible for actively engaging and ...
Care Coordinator
Middletown, RI · On-site
$23 - $25/hr
Time Management: You are a conscious planner and a thoughtful decision maker who adheres to ... We are seeking an experienced Care Coordinator who will be responsible for actively engaging and ...
Care Coordinator
Middletown, RI · On-site
$23 - $25/hr
Time Management: You are a conscious planner and a thoughtful decision maker who adheres to ... We are seeking an experienced Care Coordinator who will be responsible for actively engaging and ...
Care Coordinator
Middletown, RI · On-site
$23 - $25/hr
Time Management: You are a conscious planner and a thoughtful decision maker who adheres to ... We are seeking an experienced Care Coordinator who will be responsible for actively engaging and ...
Quick apply
Care Coordinator
Middletown, RI · On-site
$23 - $25/hr
Time Management: You are a conscious planner and a thoughtful decision maker who adheres to ... We are seeking an experienced Care Coordinator who will be responsible for actively engaging and ...
Provides coordinated care support to the Surgical Services, Total Joint Center, Case Management ... served and in utilization management. Demonstrated knowledge and skills necessary to provide ...
Provides coordinated care support to the Surgical Services, Total Joint Center, Case Management ... served and in utilization management. Demonstrated knowledge and skills necessary to provide ...
Infection Preventionist
Providence, RI · Remote
$50/hr
... Care Coordination & Case Management, Population Health & Value-Based Care, and Managed Care & Utilization Management. Benefits Full-time or part-time remote position Choose which projects you want to ...
Infection Preventionist
Providence, RI · Remote
$50/hr
... Care Coordination & Case Management, Population Health & Value-Based Care, and Managed Care & Utilization Management. Benefits Full-time or part-time remote position Choose which projects you want to ...
Provides coordinated care support to the Surgical Services, Total Joint Center, Case Management ... served and in utilization management. Demonstrated knowledge and skills necessary to provide ...
Provides coordinated care support to the Surgical Services, Total Joint Center, Case Management ... served and in utilization management. Demonstrated knowledge and skills necessary to provide ...
Patient Care Coordinator
$41K - $48K/yr
The Patient Care Coordinator (PCC) is the welcoming face of our clinic, creating a positive ... This role focuses on managing the clinic, building patient relationships, understanding patients ...
Patient Care Coordinator
$41K - $48K/yr
The Patient Care Coordinator (PCC) is the welcoming face of our clinic, creating a positive ... This role focuses on managing the clinic, building patient relationships, understanding patients ...
Health Plan Liaison
Providence, RI · Remote
$50/hr
... Care Coordination & Case Management, Population Health & Value-Based Care, and Managed Care & Utilization Management. Benefits Full-time or part-time remote position Choose which projects you want to ...
Health Plan Liaison
Providence, RI · Remote
$50/hr
... Care Coordination & Case Management, Population Health & Value-Based Care, and Managed Care & Utilization Management. Benefits Full-time or part-time remote position Choose which projects you want to ...
Community Health Worker
Providence, RI · Remote
$50/hr
... Care Coordination & Case Management, Population Health & Value-Based Care, and Managed Care & Utilization Management. Benefits Full-time or part-time remote position Choose which projects you want to ...
Community Health Worker
Providence, RI · Remote
$50/hr
... Care Coordination & Case Management, Population Health & Value-Based Care, and Managed Care & Utilization Management. Benefits Full-time or part-time remote position Choose which projects you want to ...
Patient Care Coordinator
$4.10K - $48K/yr
Join us as a Patient Care Coordinator at the Cranston Hearing Center, in Cranston, RI The Patient ... This role focuses on managing the clinic, building patient relationships, understanding patients ...
Patient Care Coordinator
$4.10K - $48K/yr
Join us as a Patient Care Coordinator at the Cranston Hearing Center, in Cranston, RI The Patient ... This role focuses on managing the clinic, building patient relationships, understanding patients ...
Patient Care Coordinator
Cranston, RI · On-site
$4.10K - $48K/yr
Join us as a Patient Care Coordinator at the Cranston Hearing Center, in Cranston, RI The Patient ... This role focuses on managing the clinic, building patient relationships, understanding patients ...
Patient Care Coordinator
Cranston, RI · On-site
$4.10K - $48K/yr
Join us as a Patient Care Coordinator at the Cranston Hearing Center, in Cranston, RI The Patient ... This role focuses on managing the clinic, building patient relationships, understanding patients ...
Patient Care Coordinator
Cranston, RI · On-site
$4.10K - $48K/yr
Join us as a Patient Care Coordinator at the Cranston Hearing Center, in Cranston, RI The Patient ... This role focuses on managing the clinic, building patient relationships, understanding patients ...
Patient Care Coordinator
Cranston, RI · On-site
$4.10K - $48K/yr
Join us as a Patient Care Coordinator at the Cranston Hearing Center, in Cranston, RI The Patient ... This role focuses on managing the clinic, building patient relationships, understanding patients ...
Community Care Coordinator (44286)
$18.50 - $25/hr
Under the direction of a Medical Case Manager, performs ongoing care coordination activities. This includes: * Conducting outreach * Completing HRA and initial health screening * Providing telephonic ...
Community Care Coordinator (44286)
$18.50 - $25/hr
Under the direction of a Medical Case Manager, performs ongoing care coordination activities. This includes: * Conducting outreach * Completing HRA and initial health screening * Providing telephonic ...
Community Care Coordinator (44286)
Smithfield, RI · On-site
$18.50 - $25/hr
Under the direction of a Medical Case Manager, performs ongoing care coordination activities. This includes: * Conducting outreach * Completing HRA and initial health screening * Providing telephonic ...
Community Care Coordinator (44286)
Smithfield, RI · On-site
$18.50 - $25/hr
Under the direction of a Medical Case Manager, performs ongoing care coordination activities. This includes: * Conducting outreach * Completing HRA and initial health screening * Providing telephonic ...
Remote Prior Authorization Pharmacist
Providence, RI · Remote
$58.75 - $70.75/hr
Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. * Skills: Excellent clinical review ...
Remote Prior Authorization Pharmacist
Providence, RI · Remote
$58.75 - $70.75/hr
Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. * Skills: Excellent clinical review ...
Remote Prior Authorization Pharmacist
Woonsocket, RI · Remote
$55.75 - $67/hr
Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. * Skills: Excellent clinical review ...
Remote Prior Authorization Pharmacist
Woonsocket, RI · Remote
$55.75 - $67/hr
Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. * Skills: Excellent clinical review ...
Utilization Management Care Coordinator information
See Rhode Island salary details
$15.54 - $18.28
7% of jobs
$20.79 is the 25th percentile. Wages below this are outliers.
$18.28 - $21.02
19% of jobs
$21.02 - $23.76
22% of jobs
The median wage is $24.03 / hr.
$23.76 - $26.49
11% of jobs
$26.49 - $29.23
4% of jobs
$29.23 - $31.97
5% of jobs
$33.13 is the 75th percentile. Wages above this are outliers.
$31.97 - $34.71
14% of jobs
$34.71 - $37.45
10% of jobs
$37.45 - $40.19
4% of jobs
$40.19 - $42.93
2% of jobs
$42.93 - $45.67
1% of jobs
$15
$28
$45
How much do utilization management care coordinator jobs pay per hour?
As of May 28, 2026, the average hourly pay for utilization management care coordinator in Rhode Island is $29.00, according to ZipRecruiter salary data. Most workers in this role earn between $20.96 and $33.89 per hour, depending on experience, location, and employer.
What is the difference between Utilization Management Care Coordinator vs Utilization Review Nurse?
| Aspect | Utilization Management Care Coordinator | Utilization Review Nurse |
|---|---|---|
| Credentials | RN or licensed healthcare professional | RN, with licensing required |
| Work Environment | Insurance companies, healthcare organizations, utilization review teams | Hospitals, insurance companies, outpatient facilities |
| Primary Focus | Coordinate care, review medical necessity, facilitate approvals | Assess medical records, review appropriateness of care, make determinations |
Both roles involve reviewing medical cases, but the Utilization Management Care Coordinator focuses on coordinating care and facilitating approvals, while the Utilization Review Nurse primarily assesses medical records to determine the necessity of services. They often work together within healthcare and insurance settings to ensure appropriate patient care and resource utilization.
What are popular job titles related to Utilization Management Care Coordinator jobs in Rhode Island? For Utilization Management Care Coordinator jobs in Rhode Island, the most frequently searched job titles are:
What job categories do people searching Utilization Management Care Coordinator jobs in Rhode Island look for? The top searched job categories for Utilization Management Care Coordinator jobs in Rhode Island are:
What cities in Rhode Island are hiring for Utilization Management Care Coordinator jobs? Cities in Rhode Island with the most Utilization Management Care Coordinator job openings:
Job description
Please note: Actual location may vary., RI
Contract
Job Description:
· Participates in the development and ongoing implementation of QM Work Plan activities.
· Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet QM objectives
Responsibilities:
· Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations.
· Considers all documented system information as well as any additional records/data presented to develop a determination or recommendation.
· Data gathering requires navigation through multiple system applications.
· Staff may be required to contact the providers of record, vendors, or internal Aetna departments to obtain additional information.
· Evaluates documentation/information to determine compliance with clinical policy, regulatory and accreditation guidelines.
· Responsible for the review and evaluation of clinical information and documentation.
· Reviews documentation and interprets data obtained form clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and/or provider issues.
· Works Potential Quality of Care cases across all lines of business (Commercial and Medicare).
· Independently coordinates the clinical resolution with internal/external clinician support as required.
· Processes and evaluates complex data and information sets -Converts the results of data analysis into meaningful business information and reaches conclusions about the data
· Prepares and completes QM documents based on interpretation and application of business requirements
· Documents QM activities to demonstrate compliance with business, regulatory, and accreditation requirements
· Assists in the development and implementation of QM projects and activities
· Accountable for completing and implementation of QM Work Plan Activities
Experience:
· 3+ years of experience as an RN
· 1+ years of inpatient hospital experience
· Registered Nurse in state of residence
· Must have prior authorization utilization experience
· Able to work in multiple IT platforms/systems
Skills:
· MUST HAVE MEDCOMPASS or ASSURECARE exp.
· MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge.
· MUST HAVE UM experience, inpatient utilization management review.
· MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG.
· MUST HAVE 6 months of Prior Authorization.
Education:
· Active and unrestricted RN licensure in state of residence
About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com (http://www.ustechsolutionsinc.com/) .
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
About US Tech Solutions
Sourced by ZipRecruiter
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.
Industry
It services
Company size
1,001 - 5,000 Employees
Headquarters location
Jersey City, NJ, US
Year founded
2000