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Utilization Management Coordinator Jobs (NOW HIRING)

UHS

Utilization Management Coordinator

Forest Park, IL · On-site

$30 - $46/hr

We are currently seeking an Utilization Management Coordinator position for Riveredge Hospital. Simply apply to the posting and discuss your interests with the hiring manager if you are selected to ...

UHS

Utilization Management Coordinator

Houston, TX · On-site

Responsibilities Utilization Management Coordinator -Full-time Opportunity West Oaks Hospital has provided psychiatric care to the Houston area and surrounding communities for over four decades. Our ...

UHS

Utilization Management Coordinator

Houston, TX · On-site

Responsibilities Utilization Management Coordinator -Full-time Opportunity West Oaks Hospital has provided psychiatric care to the Houston area and surrounding communities for over four decades. Our ...

UHS

UTILIZATION COORDINATOR

Memphis, TN · On-site

Responsibilities Utilization Management Coordinator Compass Intervention Center is seeking a dynamic and talented Utilization Management Coordinator. Our mission is to provide superior behavioral ...

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$29

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How much do utilization management coordinator jobs pay per hour?

As of Jul 6, 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 are the key skills and qualifications needed to thrive as a Utilization Management Coordinator, and why are they important?

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.

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.

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.
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Utilization Management Coordinator jobs near you
Infographic showing various Utilization Management Coordinator job openings in the United States as of June 2026, with employment types broken down into 14% As Needed, 72% Full Time, and 14% Part Time. Highlights an 83% Physical, 1% Hybrid, and 16% Remote job distribution, with an average salary of $61,585 per year, or $29.6 per hour.
Utilization Management Coordinator

Utilization Management Coordinator

Independent Living Systems

Miami, FL • On-site

Full-time

Posted 19 days ago

Be an early applicant

Independent Living Systems rating

6.5

Company rating: 6.5 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

Job description

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 Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.

About the Role:

The Utilization Management Coordinator plays an essential role in ensuring that the authorization requests are processed effectively. The Utilization Management Coordinator reviews the prior authorization form received for documentation completeness and determines if the requested service requires an authorization. This role includes inbound and outbound communication with both internal and external customers. Ultimately, the Utilization Management Coordinator contributes to improving member outcomes by facilitating timely access to necessary care.

Minimum Qualifications:

  • High school diploma or equivalent required
  • 2 years of experience as a medical office referral/authorization clerk, office assistant or other medical office experience.
  • Strong knowledge of healthcare regulations, and medical terminology.
  • Relevant experience may substitute for the educational requirement on a year-for-year basis.

Preferred Qualifications:

  • Associate degree in Health Administration, or a related healthcare field
  • Certification in Utilization Review (e.g., Certified Professional in Utilization Review - CPUR) or Case Management (e.g., CCM).
  • Experience working within managed care organizations or health insurance companies.
  • Familiarity with regulatory requirements such as Florida Medicaid/SMMC and CMS guidelines, HIPAA and current health plan accreditation standards,.

Responsibilities:

  • Demonstrate commitment to Our Mission and models ILS Experience Standards of Excellence.
  • Continuously reviews prior authorization requests received via oral, provider portal, fax and/or email to ensure timely processing.
  • Screens prior authorization requests for appropriate referral to the Clinical Care Specialist.
  • Performs non-medical research including eligibility verification, reviewing the prior authorization grid to confirm if services do or do not require prior authorization.
  • Places outbound calls to providers to request clinical information for review.
  • Perform other duties as assigned.

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