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Utilization Management Coordinator Ii Jobs (NOW HIRING)

Smokey Point Behavioral Hospital

$35 - $39/hr

Experience : At least two (2) years' experience in a healthcare setting or managed care company ... Join us as our LPN Utilization Management Coordinator! Get to know us Outstanding Care ...

UHS

Utilization Management Coordinator - PRN

Phoenix, AZ · On-site

... coordination of patient care, daily clinical reviews, quality documentation, appeals, and reporting ... Performs timely, daily clinical reviews with all payer types (Managed Medicare, Managed Medicaid ...

UF Health

RN, Utilization Management

Saint Johns, FL · On-site

Utilization Management Coordinator Plays a critical role in evaluating patient medical records to ensure the necessity and appropriateness of healthcare services. Involves coordinating with health ...

Smokey Point Behavioral Hospital

$34 - $38/hr

As the Utilization Management Coordinator, you will support patients and the treatment team by ... At least two (2) years of experience in a healthcare setting or managed care company, with ...

Southcarolinablues

Summary We are currently hiring for a Utilization Management Coordinator I to join BlueCross ... Required Work Experience: 2 years' working experience as LPN or LBSW * Required Skills and ...

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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 12, 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?

For Utilization Management Coordinator Ii jobs, the most frequently searched job titles are:

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, 82% Full Time, 15% Part Time, and 2% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $61,585 per year, or $29.6 per hour.

UTILIZATION MANAGEMENT COORDINATOR I MSO

Burlingame, CA • On-site

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

$38/hr

Full-time

Medical, Dental, Vision, Retirement

Re-posted 10 days ago

Job description

The Utilization Management Coordinator I functions under the direct supervision of a physician or Registered Nurse, performing utilization management (UM) and care coordination duties for the NEMS MSO.

ESSENTIAL JOB FUNCTIONS:

  • Review daily all incoming Referral Requests and Treatment Authorization Requests for inpatient and outpatient services.
  • Process and approve authorization requests according to the NEMS MSO Authorization Grid and to established clinical guidelines.
  • Must meet the quantitative productivity standard of 250 authorizations per week for the outpatient UM Coordinator and 115 authorizations per week for the inpatient UM Coordinator.
  • For complex cases, research additional relevant clinical guidelines from different sources.
  • Responsible to prepare and present complex cases to Medical Director for review; confirm Medical Director's approval/modification/denial decision for record tracking.
  • Perform Care Coordination activities with members, families, specialists, and ancillary providers for authorized services.
  • Perform customer service for UM inquiries to Primary Care Physician, specialist, and members.
  • Stay current with DHCS regulations, Health Plan agreements, and Industry Standard guidelines applicable to healthcare programs.
  • Communicate UM related information and updates to all members of the health care team, patients, and their families.
  • Follow the appropriate turnaround timeframe for decisions and notification of members and providers.
  • Performs other job duties as required by manager/supervisor.
  • Completion of a 2-year degree or higher.
  • Knowledge of medical terminology.
  • Completion of a recognized Medical Assistant degree or certificate a plus.
  • Excellent data entry skills.
  • Working knowledge of managed-care a plus.
  • Strong communication, analytical, and problem-solving skills.
  • Knowledge of community resources and cultural needs.
  • Good organization and prioritization skills, outstanding in time management.
  • Recent experience in a clinic or outpatient setting desirable; able to perform efficiently and appropriately in a busy environment.

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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