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Utilization Management Coordinator Jobs in Santa Rosa, CA

NeoDym Technologies

RN Manager

Santa Rosa, CA · On-site

$186K - $294K/yr

... coordination, discharge planning, utilization management, and quality outcomes across the continuum of care. The manager will collaborate with physicians, nurses, social workers, and ...

Sutter Health

Care Manager II, Acute ( RN )

Novato, CA · On-site

$90.58 - $126.81/hr

Responsible for Care Coordination and Care Transitions Planning throughout the acute care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical ...

Sutter Health

Care Manager II, Acute ( RN )

Novato, CA · On-site

$90.58 - $126.81/hr

Responsible for Care Coordination and Care Transitions Planning throughout the acute care patient experience. This position works in collaboration with the Physician, Utilization Manager, Medical ...

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Utilization Management Coordinator information

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How much do utilization management coordinator jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for utilization management coordinator in Santa Rosa, CA is $32.37, according to ZipRecruiter salary data. Most workers in this role earn between $23.41 and $37.84 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 job categories do people searching Utilization Management Coordinator jobs in Santa Rosa, CA look for?

The top searched job categories for Utilization Management Coordinator jobs in Santa Rosa, CA are:

What cities near Santa Rosa, CA are hiring for Utilization Management Coordinator jobs?

Cities near Santa Rosa, CA with the most Utilization Management Coordinator job openings:

Utilization Management Coordinator jobs near you
Infographic showing various Utilization Management Coordinator job openings in Santa Rosa, CA as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 19% Part Time, 1% Temporary, and 2% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $67,333 per year, or $32.4 per hour.

RN - Case Manager

Providence Santa Rosa Memorial Hospital - Case Management

Santa Rosa, CA • On-site

Other

Posted 9 days ago

Job description

RN - Case Manager

About the Position

Specialty: RN Case Manager

Experience: 1+ year of recent case management or discharge planning experience preferred

License: Active State or Compact RN License

Certifications: BLS – AHA

Must-Have: Strong assessment, discharge planning, and utilization review skills

Description: The RN Case Manager coordinates patient care plans and services across the continuum of care. Works closely with providers, social workers, and external agencies to ensure timely, efficient, and effective discharge planning and transitions. Supports utilization management and ensures compliance with payer guidelines. Onboarding typically takes 2–4 weeks based on documentation and clearance processes.

Requirements

Required for Onboarding:

  • Active RN License
  • BLS

Client Details

Address: 1165 Montgomery Drive, Santa Rosa, CA, 95405

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