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Utilization Review Coordinator Jobs (NOW HIRING)

UHS

Utilization Review Coordinator

Augusta, GA

The Utilization Review Coordinator opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care; ensuring ...

UHS

Utilization Review Coordinator

Augusta, GA

The Utilization Review Coordinator opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care; ensuring ...

UHS

Utilization Review Coordinator

Augusta, GA · On-site

The Utilization Review Coordinator opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care; ensuring ...

UHS

Utilization Review Coordinator

Champaign, IL · On-site

Responsibilities Full-time Utilization Review Coordinator Opening The Pavilion Behavioral Health System has been the leading provider of behavioral health and addictions treatment for families in ...

UHS

Utilization Review Coordinator

Champaign, IL

Responsibilities Full-time Utilization Review Coordinator Opening The Pavilion Behavioral Health System has been the leading provider of behavioral health and addictions treatment for families in ...

UHS

Utilization Review Coordinator

Scottsdale, AZ · On-site

Responsibilities Utilization Review Coordinator Full Time and PRN/Per Diem available Via Linda Behavioral Hospital is a behavioral health provider serving Scottsdale and the greater Phoenix area. We ...

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All JobsUtilization Review Coordinator Jobs

Utilization Review Coordinator information

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How much do utilization review coordinator jobs pay per hour?

As of Jul 6, 2026, the average hourly pay for utilization review 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.

How does a Utilization Review Coordinator typically collaborate with healthcare providers and insurance companies?

A Utilization Review Coordinator regularly communicates with both healthcare providers and insurance companies to ensure that patients receive appropriate care while managing costs. They review medical records and treatment plans, discuss cases with physicians to clarify medical necessity, and submit documentation to insurance payers for approval. This role requires strong interpersonal skills, as coordinators often need to negotiate coverage decisions and resolve discrepancies between clinical teams and insurers. Effective collaboration ensures timely authorizations and helps avoid unnecessary delays in patient care.

Is utilization review work from home?

Utilization Review Coordinators often have the option to work remotely, especially in organizations that support telecommuting. However, some employers may require in-office presence for certain tasks or meetings, and remote work policies can vary by company and role requirements. Strong communication skills and familiarity with electronic health records are important for remote utilization review work.

What degree do I need for utilization review?

Utilization Review Coordinators typically need at least a bachelor's degree in healthcare, nursing, health administration, or a related field. Some positions may require a registered nurse (RN) license or relevant certifications, such as Certified Professional in Healthcare Quality (CPHQ). Experience in medical coding, insurance, or clinical settings can also be beneficial.

What does a utilization management coordinator do?

A utilization management coordinator reviews medical records and treatment plans to ensure they meet insurance and healthcare guidelines. They assess the necessity and appropriateness of services, often using healthcare management software, to facilitate approval or denial of claims and support cost-effective patient care. Strong knowledge of healthcare policies and attention to detail are essential for this role.

What does a Utilization Review Coordinator do?

A Utilization Review Coordinator is responsible for evaluating the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, treatment plans, and insurance information to ensure that care meets established guidelines and regulatory requirements. By coordinating between healthcare providers, insurance companies, and patients, Utilization Review Coordinators help optimize resource use and manage healthcare costs while ensuring quality patient care.

What is the difference between Utilization Review Coordinator vs Utilization Review Nurse?

AspectUtilization Review CoordinatorUtilization Review Nurse
CredentialsTypically requires a healthcare-related certification or associate degreeRegistered Nurse (RN) license required
Work EnvironmentOffice setting, administrative tasks, coordinationClinical setting, patient chart review, direct communication with healthcare providers
Employer & IndustryInsurance companies, healthcare organizationsHospitals, insurance companies, healthcare providers
Common Search & ComparisonFocuses on administrative review processesInvolves clinical assessment and patient care considerations

While both roles involve reviewing healthcare utilization, the Utilization Review Coordinator primarily handles administrative and coordination tasks, often without direct patient contact, whereas the Utilization Review Nurse performs clinical assessments as a licensed RN, often in hospital or clinical settings. Understanding these differences helps job seekers identify the right role based on their credentials and career goals.

What are the key skills and qualifications needed to thrive as a Utilization Review Coordinator, and why are they important?

To thrive as a Utilization Review Coordinator, you need expertise in healthcare regulations, clinical guidelines, and case management, often supported by an RN license or a background in health administration. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of insurance approval processes are typically required. Strong analytical thinking, attention to detail, and effective communication skills help you collaborate with providers and advocate for appropriate patient care. These skills ensure compliance, optimize resource use, and support quality care delivery within healthcare organizations.

What is the highest paying job as a coordinator?

The highest paying roles for utilization review coordinators often include senior or managerial positions such as Utilization Review Manager or Director, which can offer higher salaries due to increased responsibilities and experience requirements. Advanced certifications like Certified Professional in Healthcare Quality (CPHQ) or extensive experience can also lead to higher compensation within the field.
More about Utilization Review Coordinator jobs
What cities are hiring for Utilization Review Coordinator jobs? Cities with the most Utilization Review Coordinator job openings:
What are the most commonly searched types of Utilization Review jobs? The most popular types of Utilization Review jobs are:
Who are the top companies hiring for Utilization Review Coordinator jobs? The top employers for Utilization Review Coordinator jobs are:
What states have the most Utilization Review Coordinator jobs? States with the most job openings for Utilization Review Coordinator jobs include:
What job categories do people searching Utilization Review Coordinator jobs look for? The top searched job categories for Utilization Review Coordinator jobs are:
Utilization Review Coordinator jobs near you
Infographic showing various Utilization Review Coordinator job openings in the United States as of June 2026, with employment types broken down into 1% As Needed, 82% Full Time, 14% Part Time, and 3% Contract. Highlights an 90% Physical, 2% Hybrid, and 8% Remote job distribution, with an average salary of $61,585 per year, or $29.6 per hour.
Utilization Review Coordinator

Utilization Review Coordinator

Human Resources

Morrilton, AR • On-site

$50K - $65K/yr

Full-time

Posted 18 days ago

Job description

Utilization Review Coordinator
Schedule:

  • 8:30am-5pm M-F

Compensation:

  • $50K-$65K per year

We’re looking for people who are excited to join our passionate, authentic, and courageous team. We’re uncompromising in the pursuit of excellence: our core values are more than just words on a page — we live and breathe them. To work at our company is to make a promise to help our patients achieve their wildest dreams. Our mission is to unlock human potential and save a million lives over the next hundred years.

Our company operates Residential Treatment Programs for individuals with Substance Abuse Disorder. We seek not merely to restore sobriety, but to transform our patients’ worlds from a state of darkness to vibrant technicolor. We believe that treatment is local, individualized, holistic, and relational.

Summary
The Utilization Review Coordinator performs all functions related to utilization review. This role acts as a clinical liaison between payers and facilities, providing information and feedback to assist in optimal patient care reimbursement. The coordinator partners with Revenue Cycle Management to ensure all processes are managed effectively.

Responsibilities

  • Ensure all provided care is authorized within contractual timelines

  • Initiate precertification for patients entering treatment programs using clinical knowledge

  • Conduct concurrent reviews on patients to ensure documentation meets insurance requirements for level of care

  • Track patients across locations to ensure timely and accurate billing

  • Implement quality control by communicating effectively with treatment teams

  • Obtain authorization for patients in Medicaid facilities

  • Lead retroactive appeals to obtain authorization for discharged patients

  • Collaborate with Revenue Cycle Management to resolve related issues

Minimum Qualifications

  • Bachelor’s degree in behavioral health or related field required

  • 1-2 years of professional clinical experience

  • Clinical license preferred

  • Familiarity with SharePoint and Excel

  • Proficiency in Microsoft Office

At our company, we value diversity and are proud to be an Equal Employment Opportunity Employer. We respect the time and energy it takes to apply and will respond promptly to your application. Thank you for your interest in joining our team.

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