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Utilization Management Coordinator Jobs in Ohio (NOW HIRING)

New Vista Behavioral Health

UM Coordinator

Cincinnati, OH · On-site

$18 - $24/hr

Position Summary The Utilization Management (UM) Coordinator supports the facility's utilization review and authorization processes for patients receiving mental health and behavioral health services.

TriHealth

Care Management Coord RN

Oxford, OH · On-site

We are looking for a Care Mgmt Coord RN at McCullough-Hyde/TriHealth Facility in Oxford, OH Make a ... Performs utilization review for patients served. Requires weekend, holiday, and off site commitment ...

TriHealth, Inc.

Care Management Coord RN

Oxford, OH

We are looking for a Care Mgmt Coord RN at McCullough-Hyde/TriHealth Facility in Oxford, OH Make a ... Performs utilization review for patients served. Requires weekend, holiday, and off site commitment ...

Elevance Health

Utilization Management Rep I

Mason, OH · On-site

The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review. How you will make an impact: * Managing incoming calls or ...

New

TriHealth

Care Management Coord RN

Oxford, OH · On-site

We are looking for a Care Mgmt Coord RN at McCullough-Hyde/TriHealth Facility in Oxford, OH Make a ... Performs utilization review for patients served. Requires weekend, holiday, and off site commitment ...

Elevance Health

Utilization Management Rep I

Mason, OH · On-site

The Utilization Management Representative I is responsible for coordinating cases for precertification and prior authorization review. ??How you will make an impact: * Managing incoming calls or ...

New

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Utilization Management Coordinator information

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$15

$28

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How much do utilization management coordinator jobs pay per hour?

As of Aug 24, 2026, the average hourly pay for utilization management coordinator in Ohio is $28.15, according to ZipRecruiter salary data. Most workers in this role earn between $20.34 and $32.88 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.

What are the most commonly searched types of Utilization Management jobs in Ohio?

The most popular types of Utilization Management jobs in Ohio are:

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

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

What job categories do people searching Utilization Management Coordinator jobs in Ohio look for?

The top searched job categories for Utilization Management Coordinator jobs in Ohio are:

What cities in Ohio are hiring for Utilization Management Coordinator jobs?

Cities in Ohio with the most Utilization Management Coordinator job openings:

Utilization Management Coordinator jobs near you
Infographic showing various Utilization Management Coordinator job openings in Ohio as of August 2026, with employment types broken down into 1% As Needed, 87% Full Time, 10% Part Time, and 2% Contract. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution, with an average salary of $58,548 per year, or $28.1 per hour.

Utilization Management (UM) Coordinator

Communicarehealth

Blue Ash, OH • On-site

$27 - $34/hr

Full-time

Re-posted yesterday

Job description

Job Address:

10123 Alliance Road, Suite 320 Blue Ash, OH 45242


Kids Thrive is currently recruiting a Utilization Management (UM) Coordinator to join our team!

Position Summary:

The UM Coordinator works with the Director of UM by providing the precertification and recertification process, peer to peer reviews, and appeal. The UM Coordinator will ensure an appropriate discharge plan is in place for each patient discharge. The UM Coordinator will accurately report the authorization, denials, and appeals status of patients to the UM Director. They follow department and facility procedures and ensure effective communication with all relevant departments regarding patient care needs.

Estimated Pay Range: $27-34/hr

Job Duties:

  • Responds to the request for services including the determination of appropriate level of care, initial authorization, the concurrent review process, and appropriate discharge planning.
  • Reviews the quality of documentation for each level of care to ensure clinical effectiveness and appropriateness of treatment.
  • Participates in clinical team review and evaluation of services offered at the facility to ensure goals and objectives are consistent throughout programs and facility expectations.
  • Meets regularly with the UM Director to ensure compliance with program goals and objectives.
  • Maintains an active involvement and awareness of all patient admissions, discharges and transfers to alternate levels of care. Works towards continuity of care for each level of care transition.
  • Provides assistance with the coordination with managed care companies or other third-party payors regarding peer reviews, retrospective reviews and appeals. Documents and updates the denial log to reflect same.
  • Maintains logs of all certifications and denials along with updated status of same.
  • Maintains processes to minimize denials and communication of same to the CFO and Business Office Manager.
  • Reviews benefit verifications and updates for level of care benefits with the Business Office to ensure and optimize maximum patient care and treatment.
  • Ensures processes are followed to provide adequate continuity of care and communication to families/support systems as well as referral sources for treatment and aftercare planning.
  • Reports results of daily treatment team meetings all discharges and status of high risk cases such as limited benefits, peer reviews, denials, or unplanned discharges.
  • Strong working knowledge of external review organizations (ie: Medicare/Managed Care/Medicaid) with knowledge of payor resources and planning.
  • Ability to state local laws, ordinances, and practices governing involuntary hospitalization and ensure compliance with same.
  • Demonstrates an ability to be flexible, organized, and function well in stressful situations.
  • Interacts professionally with patient/family and provides explanations and verbal reassurance as necessary.
  • Maintains a good working relationship/team work both within the department and with other departments.
  • Ensures that documentation meets current standards and policies.
  • Manages and operates equipment safely and correctly.
  • Supports and maintains a culture of safety and quality.
  • Demonstrates understanding of HIPAA.
  • Demonstrates understanding of Patient Rights and Patient's Right to Report and Patient Advocacy.

Qualifications:

  • Education: Bachelor's Degree in Nursing, Social Work, Mental Health/Behavioral Sciencespreferred.
  • Experience:Directclinical experience in a psychiatric or mental health treatment setting, including managing a related function preferred. Experience in patient assessment, family motivation, treatment planning and communication with external review organizations or comparable entities.
  • License: LPN, RN, LMSW, LPC or applicable license preferred.
  • Additional Requirements:CPRcertification andHandle with Care training within30 daysof employment.May berequiredto work flexible hours and overtimeincluding evenings, weekends, and holidays.All certifications are to bemaintainedduring tenure of employment.

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