Care Coordination, Education & Support (20%): Makes appropriate referrals and contacts as ... Prior experience in utilization management, care management, or payer-side review of ABA services;
Care Coordination, Education & Support (20%): Makes appropriate referrals and contacts as ... Prior experience in utilization management, care management, or payer-side review of ABA services;
Utilization Management Clinical
$50 - $60/hr
The Utilization Manager, Registered Nurse, is an office-based nursing position responsible for ... Support case managers with recertifications, discharges, transitions of care, and care coordination.
Utilization Management Clinical
$50 - $60/hr
The Utilization Manager, Registered Nurse, is an office-based nursing position responsible for ... Support case managers with recertifications, discharges, transitions of care, and care coordination.
Utilization Management Coordinator
Forest Park, IL · On-site
$30 - $46/hr
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.
Utilization Management Coordinator
Forest Park, IL · On-site
$30 - $46/hr
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.
Utilization Management Supervisor, Non-Clinical
Los Angeles, CA · On-site
$70K - $145K/yr
... Utilization Management Assistant Director, the Utilization Management Supervisor (Non-Clinical ... Support system-related functions and operational activities related to care coordination ...
Utilization Management Supervisor, Non-Clinical
Los Angeles, CA · On-site
$70K - $145K/yr
... Utilization Management Assistant Director, the Utilization Management Supervisor (Non-Clinical ... Support system-related functions and operational activities related to care coordination ...
Temp Medical Management Care Coordinator I
$22 - $29.75/hr
Supervisor, Utilization Management GENERAL DESCRIPTION OF POSITION The Medical Management Care Coordinator I performs non-clinical supportive duties related to utilization management (UM) and care ...
Temp Medical Management Care Coordinator I
$22 - $29.75/hr
Supervisor, Utilization Management GENERAL DESCRIPTION OF POSITION The Medical Management Care Coordinator I performs non-clinical supportive duties related to utilization management (UM) and care ...
Managed Care Coordinator
$38K - $48K/yr
The Managed Care Coordinator (MCC) is expected to insure high quality, cost-effective care and ... Familiarity with utilization management/case management
Managed Care Coordinator
$38K - $48K/yr
The Managed Care Coordinator (MCC) is expected to insure high quality, cost-effective care and ... Familiarity with utilization management/case management
Utilization Management Coordinator - Remote / Telecommute
Baltimore, MD · Remote
$20 - $24/hr
Supports the Utilization Management clinical teams by assisting with non-clinical administrative ... High School Diploma. * 3 years experience in health care claims/service areas or office support.
Quick apply
Utilization Management Coordinator - Remote / Telecommute
Baltimore, MD · Remote
$20 - $24/hr
Supports the Utilization Management clinical teams by assisting with non-clinical administrative ... High School Diploma. * 3 years experience in health care claims/service areas or office support.
Three (3) years of experience in chronic disease management, care management, care coordination, utilization management, or acute clinical care. Responsibilities • Integrates National standards for ...
Three (3) years of experience in chronic disease management, care management, care coordination, utilization management, or acute clinical care. Responsibilities • Integrates National standards for ...
... Social Workers, and Coordinators). The Manager of Utilization Management is responsible for ... The Manager of Utilization Management serves as a resource to Healthfirst's care management team ...
... Social Workers, and Coordinators). The Manager of Utilization Management is responsible for ... The Manager of Utilization Management serves as a resource to Healthfirst's care management team ...
Three (3) years of experience in chronic disease management, care management, care coordination, utilization management, or acute clinical care. Responsibilities • Integrates National standards for ...
Three (3) years of experience in chronic disease management, care management, care coordination, utilization management, or acute clinical care. Responsibilities • Integrates National standards for ...
... care coordination opportunities, and ensures compliance with medical policies. When necessary ... The Utilization Management Reviewer must maintain a strong working knowledge of federal, state, and ...
... care coordination opportunities, and ensures compliance with medical policies. When necessary ... The Utilization Management Reviewer must maintain a strong working knowledge of federal, state, and ...
RN - Utilization Management
Franklin, NH · On-site
Utilization Management Registered Nurse (UM RN) Job Summary We are seeking an experienced and ... Support quality improvement initiatives and patient care coordination activities. Qualifications
RN - Utilization Management
Franklin, NH · On-site
Utilization Management Registered Nurse (UM RN) Job Summary We are seeking an experienced and ... Support quality improvement initiatives and patient care coordination activities. Qualifications
Utilization Management Nurse
Miami, FL · On-site
Utilization Management Nurse Under the supervision of the Health Services Director, the Utilization ... Authorizes services, coordinates care, and ensures timeliness and coordination of healthcare ...
New
Utilization Management Nurse
Miami, FL · On-site
Utilization Management Nurse Under the supervision of the Health Services Director, the Utilization ... Authorizes services, coordinates care, and ensures timeliness and coordination of healthcare ...
New
Using professional judgment, the Utilization Management Reviewer assesses the appropriateness of services, identifies care coordination opportunities, and ensures compliance with medical policies.
Using professional judgment, the Utilization Management Reviewer assesses the appropriateness of services, identifies care coordination opportunities, and ensures compliance with medical policies.
Using professional judgment, the Utilization Management Reviewer assesses the appropriateness of services, identifies care coordination opportunities, and ensures compliance with medical policies.
Using professional judgment, the Utilization Management Reviewer assesses the appropriateness of services, identifies care coordination opportunities, and ensures compliance with medical policies.
The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable ...
The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable ...
RN - Utilization Management
Franklin, NH · On-site
Utilization Management Registered Nurse (UM RN) Job Summary We are seeking an experienced and ... Support quality improvement initiatives and patient care coordination activities. Qualifications
RN - Utilization Management
Franklin, NH · On-site
Utilization Management Registered Nurse (UM RN) Job Summary We are seeking an experienced and ... Support quality improvement initiatives and patient care coordination activities. Qualifications
The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable ...
The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable ...
Utilization Management Coordinator
Piscataway, NJ · On-site
$71K/yr
UBHC, one of the largest providers of behavioral health care in the country, has a budget of $260 ... The primary purpose of the Utilization Management Coordinator position is to conduct utilization ...
Utilization Management Coordinator
Piscataway, NJ · On-site
$71K/yr
UBHC, one of the largest providers of behavioral health care in the country, has a budget of $260 ... The primary purpose of the Utilization Management Coordinator position is to conduct utilization ...
The Vice President, Utilization Management serves as the executive leader responsible for ... This executive will design and lead system-wide initiatives that integrate care coordination ...
The Vice President, Utilization Management serves as the executive leader responsible for ... This executive will design and lead system-wide initiatives that integrate care coordination ...
Utilization Management Care Coordinator information
See salary details
$15.87 - $18.66
7% of jobs
$21.23 is the 25th percentile. Wages below this are outliers.
$18.66 - $21.46
19% of jobs
$21.46 - $24.26
22% of jobs
The median wage is $24.54 / hr.
$24.26 - $27.05
11% of jobs
$27.05 - $29.85
4% of jobs
$29.85 - $32.65
5% of jobs
$33.83 is the 75th percentile. Wages above this are outliers.
$32.65 - $35.45
14% of jobs
$35.45 - $38.24
10% of jobs
$38.24 - $41.04
4% of jobs
$41.04 - $43.84
2% of jobs
$43.84 - $46.63
1% of jobs
$15
$29
$46
How much do utilization management care coordinator jobs pay per hour?
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.

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.
- 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.
About Ampcus
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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