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Utilization Management Care Coordinator Jobs (NOW HIRING)

Saintfrancis

Utilization Management Coordinator

Participates in treatment team or Patient Care Committee, providing information about eligibility ... utilization. Assures compliance with Managed Care Behavioral Health standards in the area of UM ...

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How much do utilization management care coordinator jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for utilization management care coordinator in the United States is $29.61, according to ZipRecruiter salary data. Most workers in this role earn between $21.39 and $34.62 per hour, depending on experience, location, and employer.

What is the difference between Utilization Management Care Coordinator vs Utilization Review Nurse?

AspectUtilization Management Care CoordinatorUtilization Review Nurse
CredentialsRN or licensed healthcare professionalRN, with licensing required
Work EnvironmentInsurance companies, healthcare organizations, utilization review teamsHospitals, insurance companies, outpatient facilities
Primary FocusCoordinate care, review medical necessity, facilitate approvalsAssess 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.

Is utilization management care coordination a stressful job?

Utilization management care coordinators often work in fast-paced healthcare environments, managing multiple cases and ensuring appropriate resource use, which can be stressful at times. The role requires strong organizational skills, attention to detail, and the ability to handle complex cases under deadlines, but stress levels vary depending on workload and support systems.

What does a utilization management care coordinator do?

A utilization management care coordinator reviews and authorizes healthcare services to ensure they are medically necessary and appropriate, often working with insurance companies and healthcare providers. They analyze patient records, coordinate approvals, and ensure compliance with policies, typically using healthcare management software and requiring knowledge of insurance and medical guidelines.
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Utilization Management Care Coordinator jobs near you
Infographic showing various Utilization Management Care Coordinator job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 14% Part Time, and 2% Contract. Highlights an 89% Physical, 2% Hybrid, and 9% Remote job distribution, with an average salary of $61,585 per year, or $29.6 per hour.

RN, Utilization Management | Utilization Management| Night | Part Time

UF Health

Gainesville, FL

Part-time

Re-posted 15 days ago

Job description

Overview

Make an impact by supporting the right care at the right time through utilization management excellence. 

???? Work Style: Onsite
???? Location: Gainesville, FL 
???? FTE:  Part-Time (.6 FTE)
⏰ Schedule: Wednesday – Thursday - 7:00 PM – 7:00 AM

Plays a critical role in evaluating patient medical records to ensure the necessity and appropriateness of healthcare services. Involves coordinating with healthcare providers to maintain compliance with utilization management guidelines and optimizing treatment plans for effective patient care and resource utilization. Requires clear communication of authorization decisions and ongoing monitoring to support timely discharge planning. Analyzes utilization data to identify trends and collaborates with interdisciplinary teams to enhance care coordination while ensuring accurate documentation and regulatory compliance.


Responsibilities
Key Responsibilities
  • Evaluates patient medical records to determine the medical necessity and appropriateness of healthcare services.
  • Coordinates with healthcare providers and care teams to ensure compliance with utilization management guidelines and payer requirements.
  • Supports effective treatment planning, patient care coordination, and appropriate resource utilization.
  • Communicates authorization decisions and utilization determinations while supporting timely discharge planning efforts.
  • Analyzes utilization management data and trends to identify opportunities for improved care coordination and operational efficiency.
  • Collaborates with interdisciplinary teams to ensure accurate documentation, regulatory compliance, and quality patient outcomes.

Qualifications
Education & Licensure
  • Registered Nurse (RN) with a current Florida nursing license required.
Experience & Skills
  • Minimum of three (3) years of experience in utilization review, utilization management, or case management required.
  • Knowledge of healthcare utilization guidelines, payer requirements, and regulatory compliance standards.
  • Experience evaluating medical necessity, treatment plans, and appropriate levels of care.
  • Strong communication and collaboration skills related to authorization determinations and care coordination.
  • Demonstrated ability to analyze utilization data, identify trends, and support patient care and discharge planning initiatives.

Apply