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Utilization Management Coordinator Jobs in Santa Rosa, CA

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Grant Manager

Santa Rosa, CA · On-site

$70K - $100K/yr

... reporting, and coordination across multiple programs and funding sources. This is a highly ... The ideal candidate brings a strong combination of grant management, financial analysis, accounting ...

Work Settings Acute Hospital Case Management/Utilization Review Admission Criteria Benefits Eligibility Care coordination Discharge Planning Needs Assessment/ Order DME Plan of Care Prior ...

Care Manager - CA

Napa, CA · On-site

$26 - $43.81/hr

The Care Manager in California plays a pivotal role in coordinating and managing comprehensive care ... optimize resource utilization within the care continuum. Minimum Qualifications: * Bachelor ...

BI Support and Management * Collaborate with HR on BI-related needs (e.g., payroll, additional ... Support BI onboarding and integration by coordinating welcome activities, tech setup (iPads, I-9s ...

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Utilization Management Coordinator information

See Santa Rosa, CA salary details

$17

$32

$50

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:

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 Manager - Care Management Full-time Day

Providence Health and Services

Petaluma, CA • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 17 days ago


Providence Health & Services rating

7.7

Company rating: 7.7 out of 10

Based on 845 frontline employees who took The Breakroom Quiz

160th of 893 rated healthcare providers


Job description

Description

RN Manager - Case Management at Petaluma Valley Hospital in Petaluma, CA. This position is Full-time and will work 8-hour, Day shifts.

Case Management is a collaborative practice including patients, caregivers, nurses, social workers, physicians, payers, support staff, other practitioners and the community. The Case Management process facilitates communication and care coordination along a continuum through effective transitional care management. Recognizing the patient's right to self-determination, the significance of the social determinants of health and the complexities of care (barriers to coping, abuse, mental health, substance use, lack of resources, psychosocial issues, etc.).

The goals of Case Management include the achievement of optimal health, access to services, advocacy, appropriate utilization of resources and collaboration with post-acute care providers to ensure patient's needs are met in the community. The Care Manager utilizes the following processes to meet the patient's individual healthcare needs: assessment, planning/intervention, implementation, care coordination, monitoring, evaluation of the plan of care and communication.

Providence caregivers are not simply valued – they're invaluable. Join our team at NorCal HealthConnect and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Required qualifications:

  • Bachelor's Degree in Nursing
  • California Registered Nurse License upon hire
  • 5 years of experience working in a healthcare role.
  • 3 years of Case Management experience within an acute care setting.
  • 1 year of healthcare leadership experience.

Preferred qualifications:

  • Master's Degree in Healthcare or related field.
  • Certified Case Manager (CCM) upon hire or Accredited Case Manager (ACM) upon hire,

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

About Providence

At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.

Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

About the Team

The Sisters of Providence and Sisters of St. Joseph of Orange have deep roots in California, bringing health care and education to communities from the redwood forests to the beach shores of Orange county - and everywhere in between. In Northern California, Providence provides health care services to Eureka, Fortuna, Healdsburg, Napa, Petaluma and Santa Rosa.

Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Requsition ID: 435224

Company: Providence Jobs

Job Category: Care Management

Job Function: Clinical Care

Job Schedule: Full time

Job Shift: Day

Career Track: Leadership

Department: 7821 CASE MANAGEMENT PV

Address: CA Petaluma 400 N McDowell Blvd

Work Location: Petaluma Valley Hospital

Workplace Type: On-site

Pay Range: $89.73 - $141.64

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

PandoLogic. Category:Healthcare, Keywords:Nurse Manager, Location:Petaluma, CA-94955

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