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Utilization Management Coordinator Jobs (NOW HIRING)

IntusCare replaces outdated technology and manual workarounds with purpose-built solutions for care coordination, risk adjustment, population health, and utilization management. IntusCare empowers ...

The Utilization Management Coordinator reports to the Utilization Management Director. UM Coordinators provide an ongoing, systematic process for the assessment of the necessity and efficiency of the ...

Responsibilities Utilization Management Coordinator Full-Time The candidate selected will be responsible for the following: The Utilization Management Coordinator is responsible for conducting ...

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Utilization Management Coordinator information

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How much do utilization management coordinator jobs pay per hour?

As of Jun 8, 2026, the average hourly pay for utilization management coordinator in the United States is $29.61, according to ZipRecruiter salary data. Most workers in this role earn between $21.39 and $34.62 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.

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.

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.
More about Utilization Management Coordinator jobs
What cities are hiring for Utilization Management Coordinator jobs? Cities with the most Utilization Management Coordinator job openings:
What are the most commonly searched types of Utilization Management jobs? The most popular types of Utilization Management jobs are:
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What states have the most Utilization Management Coordinator jobs? States with the most job openings for Utilization Management Coordinator jobs include:
RN, Utilization Management | Utilization Management

RN, Utilization Management | Utilization Management

UF Health

Saint Augustine, FL

Other

Posted 17 days ago


Job description

Overview
Make an impact by supporting the right care at the right time through utilization management excellence.
Work Style: Onsite
Location: St. Agustine, FL
FTE: Full-Time (1.0 FTE)
Schedule: Monday - Friday, 3:00 PM - 11:00 PM
Plays a critical role in evaluating patient medical records to ensure the necessity and appropriateness of healthcare services. Involves coordinating with healthcare providers to maintain compliance with utilization management guidelines and optimizing treatment plans for effective patient care and resource utilization. Requires clear communication of authorization decisions and ongoing monitoring to support timely discharge planning. Analyzes utilization data to identify trends and collaborates with interdisciplinary teams to enhance care coordination while ensuring accurate documentation and regulatory compliance.
Responsibilities
Key Responsibilities
  • Evaluates patient medical records to determine the medical necessity and appropriateness of healthcare services.
  • Coordinates with healthcare providers and care teams to ensure compliance with utilization management guidelines and payer requirements.
  • Supports effective treatment planning, patient care coordination, and appropriate resource utilization.
  • Communicates authorization decisions and utilization determinations while supporting timely discharge planning efforts.
  • Analyzes utilization management data and trends to identify opportunities for improved care coordination and operational efficiency.
  • Collaborates with interdisciplinary teams to ensure accurate documentation, regulatory compliance, and quality patient outcomes.
Qualifications
Education & Licensure
  • Registered Nurse (RN) with a current Florida nursing license required.
Experience & Skills
  • Minimum of three (3) years of experience in utilization review, utilization management, or case management required.
  • Knowledge of healthcare utilization guidelines, payer requirements, and regulatory compliance standards.
  • Experience evaluating medical necessity, treatment plans, and appropriate levels of care.
  • Strong communication and collaboration skills related to authorization determinations and care coordination.
  • Demonstrated ability to analyze utilization data, identify trends, and support patient care and discharge planning initiatives.