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Utilization Management Coordinator Jobs in Santa Rosa, CA

Veracity

RN Manager - Care Management

Petaluma, CA · On-site

Experience managing Care Management, Utilization Review, Discharge Planning, Care Coordination, or Transitional Care teams (Yes/No - details): Experience working with Social Determinants of Health ...

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Utilization Management Coordinator information

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$32

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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.

Management and Program Analyst (Staff Assistant) Temporary Not to Exceed 3 years, MBMP

US Department of the Treasury

Santa Rosa, CA • On-site

$125K/yr

Full-time, Temporary

Posted 6 days ago

U.S. Department Of The Treasury rating

8.2

Company rating: 8.2 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

308th of 848 rated public administrative organizations

Job description

WHAT IS LARGE BUSINESS & INTERNATIONAL (LB&I)?
A description of the business units can be found at: https://www.jobs.irs.gov/about/who/business-divisions
  • Position(s) are to be filled in following area(s):
    • LBI - Office of Program and Business Solutions

REVIEW THE ADDITIONAL INFORMATION BELOW FOR FURTHER DETAILSQualifications:

Federal experience is not required. Experience may have been gained in the public sector, private sector or through Volunteer Service. One year of experience refers to full-time work; part-timework is considered on a prorated basis. To ensure full credit for your work experience, please indicate dates of employment by month/day/year, and indicate number of hours worked per week, on your resume.
You must meet the following requirements by the closing date of this announcement.
QUALIFICATION REQUIRMENTS: To qualify for this position, you must meet the qualification requirements outlined below:SPECIALIZED EXPERIENCE GS-14: To be eligible for this position, you must have one (1) year of specialized experience at a level of difficulty and responsibility equivalent to the GS-13 grade level in the Federal service.Specialized experience includes:

  • Experience leading complex program evaluations, organizational studies, or cross-functional projects to assess program effectiveness, improve business operations, identify resource requirements, and develop recommendations that support organizational objectives;
  • Experience developing, evaluating, implementing, or recommending policies, procedures, operating guidance, strategic initiatives, or program improvements based on analysis of legislation, regulations, organizational priorities, program performance, or business requirements;
  • Experience analyzing program operations, resource utilization, financial information, organizational performance measures, and operational risks to identify trends, evaluate impacts, develop corrective actions, and recommend improvements that support mission accomplishment;
  • Experience planning, coordinating, and monitoring major projects or program initiatives involving multiple organizations or stakeholders, establishing priorities, resolving implementation issues, tracking milestones, and evaluating project outcomes;
  • Experience preparing executive-level reports, briefings, recommendations, decision documents, and presentations that communicate complex analytical findings and support management decisions;
  • Experience presenting recommendations, advising senior management, coordinating with internal and external stakeholders, resolving complex or sensitive issues, and communicating technical information through both oral presentations and written products.


AND
You must also meet the following requirement(s):

  • TIME AFTER COMPETITIVE APPOINTMENT (TACA): By the closing date (or if this is an open continuous announcement, by the cut-off date) specified in this job announcement, current civilian employees must have completed at least 90 days of federal civilian service since their latest non-temporary appointment from a competitive referral certificate, known as time after competitive appointment. For this requirement, a competitive appointment is one where you applied to and were appointed from an announcement open to "All US Citizens"
  • TIME IN GRADE (TIG): For positions above the GS-05,applicants must meet applicable time-in-grade requirements to be considered eligible. One year (52 weeks) at the next lower grade level is required to meet the time-in-grade requirements for the grade you are applying for. For positions at the GS-05, you cannot advance to the GS-05 if you have held a GS-02 in the past 52 weeks. There is no TIG restriction for GS-02, 03 or 04 positions.


For more information on qualifications please refer to OPM's Qualifications Standards.

Education:A college or university degree generally must be from an accredited (or pre-accredited) college or university recognized by the U.S. Department of Education. For a list of schools which meet these criteria, please refer to Department of Education Accreditation page.
FOREIGN EDUCATION: Education completed in foreign colleges or universities may be used to meet the requirements. You must show proof the education credentials have been deemed to be at least equivalent to that gained in conventional U.S. education program. It is your responsibility to provide such evidence when applying. Click here (Section 3, Explanation of Terms) or here for Foreign Education Credentialing instructions.
We recommend choosing an evaluator from a member organization of one of the following national associations of credential evaluation services: National Association of Credential Evaluation Services (NACES) or Association of International Credentials Evaluators (AICE).Employment Type: OTHER

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