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Utilization Management Coordinator Jobs (NOW HIRING)

Uloop Inc.

Utilization Management Coordinator

Miami, FL · On-site

$50 - $70/hr

Utilization Management Coordinator We are seeking a Utilization Management Coordinator to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as ...

Devoted Health

Utilization Management Coordinator

$21.70 - $27/hr

The Utilization Management Coordinator plays a vital role in supporting Clinical Operations by managing the intake, prior authorization, and clinical coordination workflows. This role ensures timely ...

Saintfrancis

Utilization Management Coordinator

Days Monday-Friday-8am-4:30pm Behavioral health/ inpatient psych/ utilization management experience ... UM Coordinators participate in treatment teams, communicating with providers the details of ...

WVU Medicine

$90 - $120/hr

The Lead Utilization Management Coordinator (UMC) assists in driving the strategic oversight, execution, and mitigation of concurrent denials to secure timely authorizations, prevent costly and ...

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How much do utilization management coordinator jobs pay per hour?

As of Sep 5, 2026, the average hourly pay for utilization management 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 does a utilization management coordinator do?

A Utilization Management Coordinator is responsible for reviewing and assessing healthcare services to ensure that patients receive appropriate care while managing costs for healthcare providers or insurance companies. They evaluate medical records, coordinate with healthcare professionals, and help determine if certain treatments or procedures are medically necessary according to established guidelines. Their goal is to optimize the use of healthcare resources, prevent unnecessary treatments, and support quality patient outcomes.

What are the key skills and qualifications needed to thrive as a utilization management coordinator?

To thrive as a Utilization Management Coordinator, you need a background in healthcare or nursing, knowledge of medical terminology, and experience in case management or utilization review, often supported by a relevant degree or certification (such as RN or LPN). Familiarity with utilization management software, electronic health records (EHRs), and insurance authorization platforms is typically required. Strong organizational skills, attention to detail, and effective communication are essential soft skills for this role. These capabilities ensure accurate review of medical cases, compliance with regulations, and efficient coordination between providers, payers, and patients.

How does a utilization management coordinator typically collaborate with clinical staff and insurance providers?

A Utilization Management Coordinator serves as a vital link between healthcare providers, clinical staff, and insurance companies. They regularly communicate with physicians and nurses to gather clinical information, review treatment plans, and ensure that proposed services meet medical necessity criteria. Coordinators also interact with insurance providers to obtain pre-authorizations, clarify coverage policies, and appeal denied claims when appropriate. Effective collaboration and strong communication skills are essential, as the role requires balancing the needs of patients, providers, and payers while ensuring timely and cost-effective care.

What degree do you need for utilization management coordinator?

A utilization management coordinator typically needs at least a bachelor's degree in healthcare administration, nursing, or a related field. Relevant certifications, such as Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects. Strong knowledge of medical terminology, insurance processes, and data analysis tools is also important.
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Utilization Management Coordinator jobs near you
Infographic showing various Utilization Management Coordinator job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, and 2% Contract. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution, with an average salary of $61,585 per year, or $29.6 per hour.

Utilization Management Coordinator

West Michigan Community Mental Health System

Ludington, MI

Full-time

Re-posted 24 days ago

Job description

The Utilization Management Coordinator is responsible for performing retrospective monitoring and audit functions relative to WMCMH utilization management processes/systems. The Utilization Management Coordinator will monitor and audit the effectiveness of the WMCMH Utilization Management processes/systems, provide data to support organizational utilization decision-making, facilitate the WMCMH Utilization Management Committee and be an active participant in the Lakeshore Regional Entity UM ROAT and other regional and state UM workgroups/committees as appropriate. The Utilization Management Coordinator will be housed on the Operations Team and will work very closely with other members of the organization.

JOB DUTIES: Utilization Management - Through retrospective review and use of both strong QI principles and strong data aggregation and analysis skills, the Utilization Management Coordinator will: Perform monitoring and audit functions (objective examination) relative to utilization management and/or effectiveness of WM utilization management (i.e., size and composition and accessibility of WM network; appropriateness of authorization bundles; compliance with WM authorization decision guidelines; ensure presence of golden thread; ensure consistent and compliant authorization decisions and supporting documentation, etc.). In response to monitoring and audit functions, facilitate the development and monitoring of performance improvement plans as appropriate. Provide/Aggregate data to support the need for new programs and/or discontinuing programs that are ineffective or inefficient

Provide/Aggregate data to support the need for incorporating new or discontinuing the use of evidence-based practices. Provide/Aggregate data to support maintenance/updates to authorization decision guidelines. Facilitate the WMCMH Utilization Management Committee Participate in the Lakeshore Regional Entity UM ROAT and other state/regional UM workgroups as appropriate.

Back-Up Coverage - Provide limited, short-term/backup coverage for other Operations or organizational Coordinators as needed.

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