ZipRecruiter

Log In

1

Utilization Management Coordinator Jobs in Washington

Ampcus

Utilization Management Coordinator

Reston, VA · On-site

Utilization Management Coordinator. Location: Reston, VA. Purpose: * Supports the Utilization Management clinical teams by assisting with non-clinical administrative tasks and responsibilities ...

New

MedStar Health

RN Utilization Management

Washington, DC · On-site

$89.07K - $162.80K/yr

Monitors utilization of all services for fraud and abuse. * Performs pre-authorization and pharmacy ... Coordinates timely review decisions and notifications per policy NCQA standards/guidelines and ...

MedStar Health

RN Utilization Mgmt

Washington, DC · On-site

$89.07K - $162.80K/yr

About the Job General Summary of Position The RN Utilization Manager will have 1-2 years of ... Coordinates timely review decisions and notifications per policy NCQA standards/guidelines and ...

next page

Showing results 1-20

People also search for

All JobsUtilization Management Coordinator JobsUtilization Management Coordinator Jobs in Washington

Utilization Management Coordinator information

See Washington salary details

$17

$33

$52

How much do utilization management coordinator jobs pay per hour?

As of May 28, 2026, the average hourly pay for utilization management coordinator in Washington is $33.53, according to ZipRecruiter salary data. Most workers in this role earn between $24.23 and $39.18 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.

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 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 most commonly searched types of Utilization Management jobs in Washington? The most popular types of Utilization Management jobs in Washington are:
What are popular job titles related to Utilization Management Coordinator jobs in Washington? For Utilization Management Coordinator jobs in Washington, the most frequently searched job titles are:
What job categories do people searching Utilization Management Coordinator jobs in Washington look for? The top searched job categories for Utilization Management Coordinator jobs in Washington are:
What cities in Washington are hiring for Utilization Management Coordinator jobs? Cities in Washington with the most Utilization Management Coordinator job openings:
Utilization Management Coordinator jobs near you
Infographic showing various Utilization Management Coordinator job openings in Washington as of May 2026, with employment types broken down into 6% As Needed, and 94% Full Time. Highlights an 71% In-person, 6% Hybrid, and 23% Remote job distribution, with an average salary of $69,751 per year, or $33.5 per hour.
Utilization Management Coordinator

Utilization Management Coordinator

Ampcus

Reston, VA • On-site

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team. Job Title: Utilization Management Coordinator. Location: Reston, VA. Purpose:
  • Supports the Utilization Management clinical teams by assisting with non-clinical administrative tasks and responsibilities related to pre-service, utilization review, care coordination and quality of care.
Essential Functions:
  • 35% Performs member or provider related administrative support which may include benefit verification, authorization creation and management, claims inquiries and case documentation.
  • 35% Reviews authorization requests for initial determination and/or triages for clinical review and resolution.
  • 20% Provides general support and coordination services for the department including but not limited to answering and responding to telephone calls, taking messages, letters and correspondence, researching information and assisting in solving problems.
  • 10% Assists with reporting, data tracking, gathering, organization and dissemination of information such as Continuity of Care process and tracking of Peer to Peer reviews.
Knowledge, Skills and Abilities (KSAs):
  • Ability to effectively participate in a multi-disciplinary team including internal and external participants., Proficient.
  • Excellent communication, organizational and customer service skills., Proficient.
  • Knowledge of basic medical terminology and concepts used in managed care., Proficient.
  • Knowledge of standardized processes and procedures for evaluating medical support operations business practices., Proficient Excellent independent judgment and decision-making skills, consistently demonstrating tact and diplomacy., Proficient.
  • Ability to pay attention to the minute details of a project or task, Proficient.
  • Experience in the use of web-based technology and Microsoft Office applications such as Word, Excel, and Power Point, Proficient.
The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes them ineligible to perform work directly or indirectly on Federal health care programs.
  • Must be able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence.
  • Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
Qualifications:
  • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
  • The requirements listed below are representative of the knowledge, skill, and/or ability required.
  • Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Preferred Qualifications:
  • Two years' experience in health care/managed care setting or previous work experience within division.
  • Knowledge of CPT and ICD-10 coding.
Education Level:
  • High School Diploma.
Experience:
  • 3 years' experience in health care claims/service areas or office support.
Ampcus is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, age, protected veterans or individuals with disabilities.
Ampcus logo

About Ampcus

Sourced by ZipRecruiter

Ampcus Inc. is a ISO 20000, ISO 27000, ISO 9001, CMMI DEV/3 SM and CMMI SVC/3 SM certified global provider of a broad range of Technology and Business consulting services. From strategy to execution, our disciplined yet flexible approach starts and ends with our clients. By listening hard and working harder, client goals become our goals. Their success is our satisfaction. It’s why our clients sleep well at night. We believe that the success of an engagement is determined by strong project management, as well as clear communication and mutual commitment working collaboratively. Our methodology begins with listening to the customer about their needs, then working with their team to gain a clear understanding of the requirements, while providing knowledge transfer of best practices for the organization.

Industry

It services

Company size

1,001 - 5,000 Employees

Headquarters location

Chantilly, VA, US

Year founded

2004

View All Ampcus Jobs

Apply