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Utilization Management Coordinator Jobs in Washington

Provides intervention and coordination to decrease avoidable delays and denial of payment ... Monitors and identifies patterns or trends in utilization management; monitors potential and actual ...

Provides intervention and coordination to decrease avoidable delays and denial of payment ... Monitors and identifies patterns or trends in utilization management; monitors potential and actual ...

Provides intervention and coordination to decrease avoidable delays and denial of payment ... Monitors and identifies patterns or trends in utilization management; monitors potential and actual ...

... avoidable utilization and ensure regulatory compliance. The Director of Case Management (DCM ... The Director supports Managers managing case management coordination and care management staff. The ...

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Utilization Management Coordinator information

See Washington salary details

$17

$33

$52

How much do utilization management coordinator jobs pay per hour?

As of Aug 23, 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 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 Washington?

The most popular types of Utilization Management 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:

Infographic showing various Utilization Management Coordinator job openings in Washington as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 10% Part Time, 2% Temporary, and 6% Contract. Highlights an 80% Physical, 2% Hybrid, and 18% Remote job distribution, with an average salary of $69,751 per year, or $33.5 per hour.

Registered Nurse - Patient Flow - Utilization Management Coordinator

SD Department of Veterans Affairs

Washington, DC • On-site

$83K/yr

Full-time

Posted 6 days ago


Job description


The Patient Flow/Utilization Management Coordinator Nurse II is responsible for coordinating patient flow and utilization management activities to promote timely, efficient, and high-quality patient care across the continuum of care. The incumbent provides clinical leadership through collaboration, communication, and coordination with interdisciplinary teams to optimize resource utilization, improve patient outcomes, and support safe transitions of care.Qualifications:Basic Requirements:
  • English Language Proficiency. In accordance with 38 U.S.C. 7403(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English.
  • Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE); OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. Upon achievement of a State license, the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program. (Reference VA Handbook 5005, Appendix G6); OR In cases of graduates of foreign schools of professional nursing, possession of a current, full, active, and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program. Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD).
  • Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia. Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements, but do not possess the required licensure, may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.)
NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and performing the duties as described in the qualification standard on the effective date of the standard (1/29/2024) are considered to have met all qualification requirements for the grade held including positive education and licensure/certification.
Grade Determinations: The following Scope, Education and Dimension criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade. The Dimension requirements (Practice, Veteran/Patient Driven Care, Leadership, Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment: https://apply.usastaffing.gov/ViewQuestionnaire/13036075.Grade/LevelScopeEducationNurse I, Level IDelivers fundamental, knowledge-based care to assigned clients while developing technical competencies.An Associate Degree (ADN) or Diploma in Nursing, with no additional professional nursing required.Nurse I, Level IIDemonstrates integration of biopsychosocial concepts, cognitive skills and technically competent practice in providing care to clients with basic or complex.An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I, Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required.Nurse I, Level IIIDemonstrates proficiency in practice based on conscious and deliberate planning. Self-directed in goal setting for managing complex client situations.An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I, Level 2; OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I, Level 2; OR a Master's degree in nursing (MSN) and no additional professional nursing experience; OR a Master's degree in a *related field with a BSN and no additional professional nursing experience.Nurse IIDemonstrates leadership in delivering and improving holistic care through collaborative strategies with others.A BSN with 2 years of professional nursing equivalent to Nurse I, Level 3; OR an MSN with one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Master's degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Doctoral degree in Nursing with no professional nursing experience; OR a Doctoral degree in a *related field with a BSN with no additional professional nursing experience.Nurse IIIExecutes position responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice setting.MSN and 2 years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Master's degree in *related field with BSN and two years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III.*Note: Foreign education programs/degrees are not creditable as related degrees.
Preferred Experience:
  • BSN
  • VA Employee or Prior VA Employee
  • Three years Acute/Critical care nursing within the last five years
  • Minimum one year Charge Nurse experience.

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.
Physical Requirements: This position requires visual acuity, keen hearing, clear distinctive speech, and manual dexterity. This position requires potentially long periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing. Transferring patients and objects may be required. Mechanical lifts are provided. The incumbent may be exposed to infected patients and contaminated materials and may be required to don protective clothing in isolation situations, operative/invasive procedures, or home settings. The incumbent may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders. Must complete annual Employee Health requirements as a condition of employment. The incumbent who provides care in home settings or other off-site locations may be required to drive and/or ride in GSA-vehicles.Education:Employment Type: OTHER