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Utilization Review Coordinator Jobs in Appleton, WI

Network Health

RN Care Manager

Menasha, WI · On-site

... coordination, evaluation and advocacy to all members across the healthcare continuum. The Care ... Review results from medical or behavioral tests and procedures and updates care plan to reflect ...

Network Health WI

RN Care Manager

Menasha, WI · On-site +1

... coordination, evaluation and advocacy to all members across the healthcare continuum. The Care ... Review results from medical or behavioral tests and procedures and updates care plan to reflect ...

New Perspective

Care Team Coordinator

Neenah, WI · On-site

$19.75 - $26.75/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Care Team Coordinator is a Caregiver/Med Passer who is also responsible for arranging staff ... For further information, please review the Know Your Rights notice from the Department of Labor.

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All JobsUtilization Review JobsUtilization Review Coordinator JobsUtilization Review Coordinator Jobs in Appleton, WI

Utilization Review Coordinator information

See Appleton, WI salary details

$15

$28

$44

How much do utilization review coordinator jobs pay per hour?

As of Aug 15, 2026, the average hourly pay for utilization review coordinator in Appleton, WI is $28.18, according to ZipRecruiter salary data. Most workers in this role earn between $20.38 and $32.93 per hour, depending on experience, location, and employer.

How does a utilization review coordinator 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.

What degree do I need for utilization review coordinator?

A utilization review coordinator typically needs at least a bachelor's degree in healthcare, nursing, health administration, or a related field. Relevant certifications, such as Certified Professional Coder (CPC) or Certified Utilization Review Professional (CURP), can enhance job prospects. Strong knowledge of medical terminology, insurance processes, and healthcare regulations is also important.

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 skills and qualifications are needed to be a utilization review coordinator?

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 are the most commonly searched types of Utilization Review jobs in Appleton, WI?

The most popular types of Utilization Review jobs in Appleton, WI are:

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For Utilization Review Coordinator jobs in Appleton, WI, the most frequently searched job titles are:

What job categories do people searching Utilization Review Coordinator jobs in Appleton, WI look for?

The top searched job categories for Utilization Review Coordinator jobs in Appleton, WI are:

What cities near Appleton, WI are hiring for Utilization Review Coordinator jobs?

Cities near Appleton, WI with the most Utilization Review Coordinator job openings:

Utilization Review Coordinator jobs near you
Infographic showing various Utilization Review Coordinator job openings in Appleton, WI as of June 2026, with employment types broken down into 1% Internship, 1% As Needed, 89% Full Time, 8% Part Time, and 1% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $58,610 per year, or $28.2 per hour.

Machine Division Business Leader

Maxcess International

Greenville, WI • On-site

Full-time

Re-posted 23 days ago

Job description

GENERAL DESCRIPTION AND POSITION SUMMARY
The Business Leader is responsible for operations of highly engineered machinery products. This position manages a team of functional department managers who drive business growth sometime working directly with the Customers and increasing levels of customer and employee satisfaction through a collaborative, team- oriented management style that coordinates the application of all functions to work as one team to support the needs of the customer. The Business Leader works to improve the utilization and efficiency of manpower, materials and machines. Oversees a workforce of 25 employees. Develops financial plans and provides timely reporting of key metrics - in coordination with Division Controllers, other managers, and Executive leadership. Prepares and achieves the operating budget and responds with urgency to changes in operating results.
ESSENTIAL JOB DUTIES & RESPONSIBILITIES
  • Leads the business and is responsible for the overall performance of all functional areas, continuous improvement, achieving budgeted results and initiatives to reduce cost and improve on-time delivery, safety, customer satisfaction and employee relations.
  • Reviews production costs and product quality, modifying production and inventory control programs to maintain and enhance profitable operation of division.
  • Ensures on time delivery of customer orders.
  • Drives more efficient use of working capital through higher inventory turns.
  • Balances Engineering Staff and work cell capacity/loading across the plant.
  • Develops plans for the maximum utilization of materials, machines and employees with a focus on creating a system that can deliver product with "Best in Class" product and lead times.
  • Ensures available capacity to meet current demand and planned growth.
  • Prioritizes, schedules and delegates work assignments and directly manages site team to ensure the achievement of strategic and operating objectives.
  • Manages compliance with state and federal regulations. Develops policies and procedures to ensure compliance with OSHA, environmental and various regulatory agencies.
  • Evaluates, recommends and implements improvements in methods and processes to increase productivity and quality through the application of advanced engineering processes, lean manufacturing and visual factory concepts.
  • Identifies, communicates and drives implementation of capital investments and improvement project.
  • Develops and recommends plant capital and operating budgets to ensure conformance to budgets.
  • Provides leadership to ensure productive work environment and positive employee relations through effective communications, coaching, training and development.
  • Provides leadership for problem resolution and to facilitate fast improvements and improved working relationships.
  • Ensures that equipment and buildings are well maintained, includes good housekeeping utilizing 5S.
  • Customer focused, collaborative and team oriented leadership style. Is fact based and acts with a sense of urgency. Behaves as a supportive and servant leader.
  • Other duties as assigned.

EDUCATION & EXPERIENCE REQUIREMENTS
  • Experienced leader with track record of success and increasing levels of responsibility.
  • Experienced in Web Management processes and the processing equipment in the industry.
  • Proficient in the understanding and use of Lean Manufacturing techniques including ability to teach others.
  • Technical skills in materials and inventory management, production scheduling, and preventive maintenance.
  • Leadership: A demonstrated ability to lead people and get results through others.
  • Planning: Ability to perform short and long range planning.
  • Excellent interpersonal and communication skills.
  • Excellent project and program management skills.
  • Understands ISO 9001 Quality system, corrective action and continuous improvement.
  • Computer proficient in use of Solid Works, Word, Excel and other tools.
  • Bachelor's Degree required - mechanical engineering preferred. MBA a plus.

LEADERSHIP & MANAGERIAL RESPONSIBILITIES
  • Site leadership and management of the site team.
  • Ownership of the P&L.
  • Collaborative and team oriented style and ability to work with peers at other locations.
  • Oversight of business plan, managers and administrative personnel.
  • Participation in company-wide improvement and growth initiatives.
  • Meeting with Customers on site during FAT reviews and major project discussions.

KEY PERFORMANCE INDICATORS (KPI'S) & SUCCESS FACTORS FOR THIS POSITION
  • Growth and profitability of the business.
  • Lower cost of quality (COQ), better on time delivery and improvement in other performance metrics.

#IND
Maxcess is an equal employment opportunity employer. We do not discriminate on the basis of race, religion, sex, disability, age, pregnancy, national origin, sexual orientation, or any other characteristic protected by applicable law. We are committed to diversity and inclusion, and all qualified candidates are encouraged to apply.

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