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Utilization Review Coordinator Jobs in Remote, OR

Umpqua Health

Utilization Review Specialist

Winston, OR · On-site

$41K - $47K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

POSITION PURPOSE The Utilization Review Specialist supports Umpqua Health Alliance by coordinating the intake, review, processing, and completion of prior authorization requests within Medical ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Collaborate with care coordinators, discharge planners, and interdisciplinary teams for care transitions * Liaise with internal departments to resolve eligibility, benefits, or service issues

Umpqua Health

Utilization Review Nurse

Roseburg, OR · Remote

$85K - $105K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Collaborate with care coordinators, discharge planners, and interdisciplinary teams for care transitions * Liaise with internal departments to resolve eligibility, benefits, or service issues

Umpqua Health

Utilization Review Clinician

Roseburg, OR · Remote

$80K - $94K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

UTILIZATION REVIEW CLINICIAN REMOTE Ability to travel on-site to 3031 NE STEPHENS ST. ROSEBURG, OR ... Care Coordination and Member Support * Collaborate with care management teams, providers, and ...

Umpqua Health

Utilization Review Clinician

Roseburg, OR · On-site +1

$80K - $94K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

UTILIZATION REVIEW CLINICIAN REMOTE Ability to travel on-site to 3031 NE STEPHENS ST. ROSEBURG, OR ... Care Coordination and Member Support * Collaborate with care management teams, providers, and ...

Reliant Rehabilitation

Therapy Coordinator

Myrtle Point, OR · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Therapy Coordinator (TC) oversees the rehabilitation department to ensure resident needs are ... utilization review, quality assurance, resident care conferences, admissions, department head ...

Reliant Rehabilitation

Therapy Coordinator

Myrtle Point, OR · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Reliant Rehabilitation Therapy Coordinator $10,000 SignOn Bonus Why Join Reliant Rehabilitation ... Participate in interdisciplinary meetings including utilization review, quality assurance, resident ...

Reliant Rehabilitation

Therapy Coordinator

Myrtle Point, OR

$40 - $50/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Therapy Coordinator (TC) oversees the rehabilitation department to ensure resident needs are ... utilization review, quality assurance, resident care conferences, admissions, department head ...

Reliant Rehabilitation

Therapy Coordinator

Myrtle Point, OR · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Therapy Coordinator (TC) oversees the rehabilitation department to ensure resident needs are ... utilization review, quality assurance, resident care conferences, admissions, department head ...

Actalent

Health Plan Nurse Coordinator

Myrtle Point, OR · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Depending on the assigned unit, this role performs utilization management activities including telephonic or onsite clinical review, case or disease management, care coordination and transitions of ...

Umpqua Health

Workforce Development Coordinator

Roseburg, OR · On-site

$71K - $84K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Review, process, and approve employee education and training requests in accordance with ... Support administration and utilization of learning management systems and employee engagement ...

Umpqua Health

Workforce Development Coordinator

Roseburg, OR · On-site

$71K - $84K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Review, process, and approve employee education and training requests in accordance with ... Support administration and utilization of learning management systems and employee engagement ...

Enterprise Engineering

UM Nurse

OR · Remote

... and coordination across settings, identifying member needs, planning for care, monitoring the ... This position is not patient facing, they will be reviewing patient records and providing ...

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All JobsUtilization Review JobsUtilization Review Coordinator JobsUtilization Review Coordinator Jobs in Remote, OR

Utilization Review Coordinator information

See Remote, OR salary details

$15

$29

$46

How much do utilization review coordinator jobs pay per hour?

As of Aug 15, 2026, the average hourly pay for utilization review coordinator in Remote, OR is $29.58, according to ZipRecruiter salary data. Most workers in this role earn between $21.39 and $34.57 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 Remote, OR?

The most popular types of Utilization Review jobs in Remote, OR are:

What are popular job titles related to Utilization Review Coordinator jobs in Remote, OR?

For Utilization Review Coordinator jobs in Remote, OR, the most frequently searched job titles are:

What job categories do people searching Utilization Review Coordinator jobs in Remote, OR look for?

The top searched job categories for Utilization Review Coordinator jobs in Remote, OR are:

What cities near Remote, OR are hiring for Utilization Review Coordinator jobs?

Cities near Remote, OR with the most Utilization Review Coordinator job openings:

Utilization Review Coordinator jobs near you
Infographic showing various Utilization Review Coordinator job openings in Remote, OR as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $61,524 per year, or $29.6 per hour.

Utilization Review Specialist

Umpqua Health

Winston, OR • On-site

$41K - $47K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 25 days ago

Job description

Utilization Review Specialist
HYBRID, must be able to travel to 3031 NE STEPHENS ST. ROSEBURG, OR 97470
EMPLOYMENT TYPE- Full-Time, Exempt
About Umpqua Health
At Umpqua Health, we're more than a healthcare organization we're a community-driven Coordinated Care Organization (CCO) dedicated to improving the health and well-being of individuals and families throughout Douglas County, Oregon. We provide integrated, whole-person care through primary care, specialty care, behavioral health services, and care coordination. Our collaborative approach ensures members receive high-quality, personalized care while supporting a stronger, healthier community.
POSITION PURPOSE
The Utilization Review Specialist supports Umpqua Health Alliance by coordinating the intake, review, processing, and completion of prior authorization requests within Medical Management. This role is responsible for ensuring accurate and timely handling of authorizations, maintaining compliance with regulatory and organizational requirements, supporting communication with providers and members, and assisting with workflow coordination to promote efficient utilization management operations.
ESSENTIAL JOB RESPONSIBILITIES
  • Support Utilization Review activities related to the prior authorization process.
  • Manage intake, tracking, and routing of prior authorization requests and supporting documentation.
  • Review requests for completeness and ensure appropriate routing for processing.
  • Communicate with healthcare providers to obtain additional information and resolve documentation issues.
  • Track prior authorization requests using established systems to ensure timely processing.
  • Support timely notification of prior authorization determinations.
  • Coordinate daily workflow and telephone coverage with team members.
  • Respond to internal and external inquiries regarding prior authorizations and route as appropriate.
  • Monitor and report on turnaround times to ensure compliance with requirements.
  • Maintain knowledge of applicable regulations, policies, and procedures.
  • Comply with organizational policies and applicable to federal, state, and local regulations.
CHALLENGES
  • Strong organizational skills with the ability to stay organized and productive in a remote, independent work environment
  • Proactive communication with internal and external stakeholders
  • Consistent ability to meet Oregon Health Plan (OHA) timeline and turnaround requirements
  • Ability to manage shifting priorities in a fast-paced environment
  • Ability to coordinate tasks and resources to meet operational goals and objectives
MINIMUM QUALIFICATIONS
  • High school diploma or equivalent.
  • Proficient computer skills, including Microsoft Office Suite (Word, Excel, Outlook, Teams), data entry, and internet research.
  • Experience using standard office equipment and systems, including keyboarding, web-based phone systems, and cloud-based document storage.
  • Ability to type a minimum of 45 words per minute with a high degree of accuracy.
  • Strong attention to detail.
  • No suspension, exclusion, or debarment from participation in federal healthcare programs (e.g., Medicare/Medicaid)
PREFERRED QUALIFICATIONS
  • 1+ years of experience in healthcare, managed care, medical coding, claims processing, or a related field
  • Knowledge of medical terminology, procedure codes, and diagnosis codes
  • Familiarity with Oregon Health Plan (OHP) and Coordinated Care Organizations (CCO), including applicable regulations (OAR, ORS, CFR, CMS, DMAP)
  • Strong organizational skills with the ability to manage multiple priorities in a fast-paced environment
  • Ability to meet deadlines while maintaining accuracy and attention to detail
  • Strong communication and customer service skills (written, verbal, and interpersonal)
  • Ability to work independently and collaboratively with sound judgment and confidentiality
  • Strong critical thinking and time management skills
  • Self-motivated with ability to follow policies, procedures, and workflows in a remote environment
  • Flexible and adaptable in a changing work environment
  • Willingness to learn and take on additional responsibilities as needed
  • Ability to work a standard schedule: Monday-Friday, 8:00 AM-5:00 PM PST
  • Experience working in diverse teams and with varied communication styles
  • Experience considering the impact of work on diverse communities, including communities of color
  • Bilingual or translation skills preferred

SCHEDULE
Monday through Friday - 8:00am - 5:00pm; standard business hours with flexibility to meet service timelines.
SALARY
Wage Band : $41,600- $47,000
BENEFITS
  • Salary is dependent on skills, experience, and education
  • Generous benefits package including vacation PTO, sick leave, federal holidays, and birthday leave
  • Medical, dental, and vision insurance
  • 401(k) with company match (fully vested immediately)
  • Company-sponsored life insurance and additional benefits
  • Fitness reimbursement program
  • Tuition reimbursement and more

Why Umpqua Health?
We are committed to advancing health equity by collaborating across communities, addressing systemic barriers, and ensuring fair access to care and resources. At Umpqua Health, every team member plays a vital role in making a meaningful impact, empowering healthier lives and strengthening the communities we serve.
Inclusive Culture
We foster a respectful, inclusive environment where employees feel valued, supported, and empowered.
Growth & Development
We support ongoing learning through mentorship, clear career pathways, and professional development opportunities.
Work/Life Balance
We promote flexibility and well-being so employees can thrive both professionally and personally.
Equal Opportunity
Umpqua Health is an equal opportunity employer that embraces individuals from all backgrounds. We prohibit discrimination and harassment of any kind, ensuring that all employment decisions are based on qualifications, merit, and the needs of the business. Our dedication to fairness and equality extends to all aspects of employment, including hiring, training, promotion, and compensation, without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, veteran status, or any other protected category under federal, state, or local law.

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