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Utilization Management Care Coordinator Jobs (NOW HIRING)

Responsibilities Shape the future of behavioral health care throughout the Forest Park community by ... We are currently seeking an Utilization Management Coordinator position for Riveredge Hospital.

The Managed Care Coordinator (MCC) is expected to insure high quality, cost-effective care and ... Familiarity with utilization management/case management

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Utilization Management Care Coordinator information

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

As of Aug 8, 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.

More about Utilization Management Care Coordinator jobs
What cities are hiring for Utilization Management Care Coordinator jobs? Cities with the most Utilization Management Care Coordinator job openings:
What states have the most Utilization Management Care Coordinator jobs? States with the most job openings for Utilization Management Care Coordinator jobs include:
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, 13% Part Time, and 3% Contract. Highlights an 88% Physical, 2% Hybrid, and 10% Remote job distribution, with an average salary of $61,585 per year, or $29.6 per hour.

Health Services - Spec, Utilization Management

Ampcus

Baltimore, MD • On-site

Other

Re-posted 10 days ago


Job description

Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team.

Job Title: Health Services - Spec, Utilization Management

Location(s): Baltimore, MD

Job Summary:

Utilizing key principles of utilization management, the Utilization Review Specialist (BCBA Licensee) performs prospective, concurrent, and retrospective reviews to determine authorization, medical necessity, and appropriateness of ABA services. The Utilization Management Specialist leverages clinical expertise in behavior analysis, evidence-based ABA practices, and critical thinking skills to evaluate treatment plans, service intensity, and clinical outcomes. This role analyzes clinical documentation, benefit plans, mandates, and medical/behavioral health policies to support determinations related to ABA services for individuals with Autism Spectrum Disorder and other developmental or behavioral diagnoses.

Key Responsibilities:
  • Clinical Review & Authorization Determination (50%): Reviews ABA treatment requests to determine medical necessity, clinical appropriateness, and benefit coverage. Applies behavior analytic principles and clinical expertise to evaluate treatment plans, goals, supervision models, and service intensity.
  • Clinical Analysis & Collaboration (30%): Conducts research and analysis of behavioral health conditions, ABA treatment methodologies, and emerging practices within the field. Collaborates with medical directors, sales and marketing, contracting, provider and member services to determine appropriate benefit application.
  • Care Coordination, Education & Support (20%): Makes appropriate referrals and contacts as appropriate. Offers assistance to members and providers for alternative settings for care. Provides guidance regarding ABA best practices, documentation standards, and authorization requirements.
Required Qualifications:
  • Education Level: Master's Degree or higher in Behavior Analysis, Psychology, Education, or a related field
  • Licensure/Certification: Board Certified Behavior Analyst (BCBA) - Required; Active state licensure as a Behavior Analyst (if applicable in practicing state) - Required
  • Experience: Minimum 3-5 years of clinical ABA experience, including development and supervision of ABA treatment programs
  • Preferred Qualifications: Prior experience in utilization management, care management, or payer-side review of ABA services; Working knowledge of managed care and health delivery systems.

Ampcus is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veterans or individuals with disabilities.


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About Ampcus

Sourced by ZipRecruiter

Ampcus Inc. is a ISO 20000, ISO 27000, ISO 9001, CMMI DEV/3 SM and CMMI SVC/3 SM certified global provider of a broad range of Technology and Business consulting services. From strategy to execution, our disciplined yet flexible approach starts and ends with our clients. By listening hard and working harder, client goals become our goals. Their success is our satisfaction. It’s why our clients sleep well at night. We believe that the success of an engagement is determined by strong project management, as well as clear communication and mutual commitment working collaboratively. Our methodology begins with listening to the customer about their needs, then working with their team to gain a clear understanding of the requirements, while providing knowledge transfer of best practices for the organization.

Industry

It services

Company size

1,001 - 5,000 Employees

Headquarters location

Chantilly, VA, US

Year founded

2004