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Utilization Management Coordinator Ii Jobs (NOW HIRING)

UHS

Utilization Management Coordinator

Chicago, IL · On-site

... wide Utilization Management Plan. Serves as liaison to 3rd and 4th party reviewers, effectively coordinating collection of all supporting data to support the hospital and patients' position.

UHS

Utilization Management Coordinator

Chicago, IL · On-site

... wide Utilization Management Plan. Serves as liaison to 3rd and 4th party reviewers, effectively coordinating collection of all supporting data to support the hospital and patients' position.

UHS

Utilization Management Coordinator

Chicago, IL · On-site

$58K - $75K/yr

... wide Utilization Management Plan. Serves as liaison to 3rd and 4th party reviewers, effectively coordinating collection of all supporting data to support the hospital and patients' position.

UHS

Utilization Management Coordinator

Chicago, IL · On-site

... wide Utilization Management Plan. Serves as liaison to 3rd and 4th party reviewers, effectively coordinating collection of all supporting data to support the hospital and patients' position.

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 ...

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Utilization Management Coordinator Ii information

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$15

$29

$46

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

As of Sep 10, 2026, the average hourly pay for utilization management coordinator ii 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 Coordinator Ii vs Utilization Review Nurse?

AspectUtilization Management Coordinator IIUtilization Review Nurse
CredentialsTypically requires a healthcare-related certification or license, such as RN or CPCRegistered Nurse (RN) license is usually required
Work EnvironmentOffice-based, healthcare insurance companies, or hospital settingsHospitals, clinics, or insurance companies
Primary ResponsibilitiesCoordinate utilization review processes, ensure compliance, and communicate with providersAssess medical necessity, review patient records, and authorize or deny services

The Utilization Management Coordinator II and Utilization Review Nurse roles share similar credentials and work environments, focusing on healthcare utilization and compliance. However, the Coordinator II often handles administrative coordination, while the Review Nurse performs clinical assessments. Both roles are essential in healthcare settings to ensure appropriate patient care and resource management.

What cities are hiring for Utilization Management Coordinator Ii jobs?

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What are popular job titles related to Utilization Management Coordinator Ii jobs?

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Utilization Management Coordinator Ii jobs near you
Infographic showing various Utilization Management Coordinator Ii job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, and 2% Contract. Highlights an 86% Physical, 2% Hybrid, and 12% Remote job distribution, with an average salary of $61,585 per year, or $29.6 per hour.

UTILIZATION MANAGEMENT COORDINATOR II MSO

Burlingame, CA • On-site

NORTH EAST MEDICAL SERVICES
Health Care and Social Assistance • 51 - 200 employees
Learn more about NORTH EAST MEDICAL SERVICESexternal

$39.69 - $45.10/hr

Full-time

Medical, Dental, Vision, Retirement

Re-posted 7 days ago

Job description

The Utilization Management Coordinator II functions under the direct supervision of a physician or Registered Nurse performing utilization management (UM) and care coordination duties for the NEMS MSO. The UM Coordinator II will also provide basic training to the junior UM Coordinators.

ESSENTIAL JOB FUNCTIONS:

  • Responsible to review Referral Requests and Treatment Authorization Requests received daily; process and approve authorization requests according to the NEMS MSO Authorization Grid and established clinical guidelines.
  • Provide guidance to junior UM Coordinators during research of additional clinical guidelines from different sources for complex cases.
  • Responsible to lead the junior UM Coordinators to prepare and present complex cases to Medical Director for review and ensure follow up activities.
  • Responsible for reviewing the confirmed MD approval/modification/denial decision and notes for record tracking purposes.
  • Responsible to prepare UM Notice of Action (NOA) to provider and member for UM denial decision per AB1455 turn-around-time requirement.
  • Responsible for preparing UM statistical reports and submit to health plans per contract requirement.
  • Perform Care Coordination activities with members, families, specialists, and ancillary providers for authorized services.
  • Perform case investigation for member and/or provider complaints and appeals related to UM denials, and report findings to Health Plan.
  • Provide transition of care services to members who are discharged from the hospital.
  • Perform customer services for UM inquires to PCP, specialist, and members.
  • Stay current with DHCS regulations, Health Plan agreements, and Industry Standard guidelines applicable to healthcare programs.
  • Communicate with Health Plan for clarification about clinical guidelines for covered/uncovered benefits.
  • Communicate UM related information and updates to all members of the health care team, patients, and their families.
  • Follows the appropriate turnaround timeframe for decisions and notification of members and providers.
  • Performs other job duties as required by manager/supervisor.
     
  • BS/BA Degree in Health Science or General Education highly preferred.
  • Minimum of one year of experience in utilization management required.
  • Recent experience in a clinic or outpatient setting desirable; able to perform efficiently and appropriately in a busy environment.
  • Current Medical Assistant Certification or California Pharmacy Technician License or equivalent experience in a health care field is a plus.
  • Knowledge of medical terminology is a must
  • Strong communication, analytical, and problem-solving skills.
  • Knowledge of community resources and cultural needs.
  • Good organization and prioritization skills, outstanding in time management.

LANGUAGE:

  • Must be able to fluently speak, read and write English.
  • Fluent in Chinese (Cantonese and/or Mandarin) preferred.
  • Fluent in other languages is an asset.

STATUS:

  • This is an FLSA Non-exempt position.
  • This is not an OSHA high-risk position.
  • This is a full-time position. 

NEMS is proud to be an Equal Opportunity Employer welcoming diversity in our workforce. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

NEMS BENEFITS: Competitive benefits, including free medical, dental and vision insurance for employee, spouse and/or children; and company contribution to 401(k).
 

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