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Utilization Review Coordinator Jobs in Springfield, MA

Lifepoint Health

Specialist, Utilization Review

Holyoke, MA · On-site

$33.22 - $44.85/hr

Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine legitimacy of admission, treatment, and length of ...

Lifepoint Health

Specialist, Utilization Review

Holyoke, MA · On-site

$33.22 - $44.85/hr

Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine legitimacy of admission, treatment, and length of ...

Lifepoint Health

Specialist, Utilization Review

Holyoke, MA · On-site

$33.22 - $44.85/hr

Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine legitimacy of admission, treatment, and length of ...

Mission Hospital

RN - Case Manager

Springfield, MA · On-site

$2.0K/wk

Strong assessment, discharge planning, and utilization review skills Description: The RN Case Manager coordinates patient care plans and services across the continuum of care. Works closely with ...

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All JobsUtilization Review JobsUtilization Review Coordinator JobsUtilization Review Coordinator Jobs in Springfield, MA

Utilization Review Coordinator information

See Springfield, MA salary details

$15

$28

$45

How much do utilization review coordinator jobs pay per hour?

As of Aug 20, 2026, the average hourly pay for utilization review coordinator in Springfield, MA is $28.82, according to ZipRecruiter salary data. Most workers in this role earn between $20.82 and $33.70 per hour, depending on experience, location, and employer.

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 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.

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 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 most commonly searched types of Utilization Review jobs in Springfield, MA?

The most popular types of Utilization Review jobs in Springfield, MA are:

What are popular job titles related to Utilization Review Coordinator jobs in Springfield, MA?

For Utilization Review Coordinator jobs in Springfield, MA, the most frequently searched job titles are:

What job categories do people searching Utilization Review Coordinator jobs in Springfield, MA look for?

The top searched job categories for Utilization Review Coordinator jobs in Springfield, MA are:

What cities near Springfield, MA are hiring for Utilization Review Coordinator jobs?

Cities near Springfield, MA with the most Utilization Review Coordinator job openings:

Utilization Review Coordinator jobs near you
Infographic showing various Utilization Review Coordinator job openings in Springfield, MA as of August 2026, with employment types broken down into 100% Full Time. Highlights an 88% In-person, and 12% Remote job distribution, with an average salary of $59,939 per year, or $28.8 per hour.

Specialist, Utilization Review

Lifepoint Health

Holyoke, MA • On-site

$33.22 - $44.85/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 6 days ago

LifePoint Health rating

5.9

Company rating: 5.9 out of 10

Based on 272 frontline employees who took The Breakroom Quiz

759th of 889 rated healthcare providers

Job description

Salary Range: $33.22 - $44.85

Your experience matters:

At Valley Springs Behavioral Hospital, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities. In your role, you'll support those that are in our facilities who are interfacing and providing care to our patients and community members. We believe that our collective efforts will shape a healthier future for the communities we serve. Our programs offer customized rehabilitation tailored to the specific needs of those recovering from a stroke, brain injury, neurological conditions, trauma, spinal cord injury, amputation or orthopedic injury.

How you'll contribute:

Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine legitimacy of admission, treatment, and length of stay and interfaces with managed care organizations, external reviewers and other payers. UR advocates on behalf of patients with substance abuse, dual diagnosis, psychiatric or emotional disorders to managed care providers for necessary treatment. UR contacts external case managers/managed care organizations for certification of insurance benefits throughout the patient's stay and assists the treatment team in understanding the insurance company's requirements for continued stay and discharge planning. 

Additional responsibilities include:

  • Displays knowledge of clinical criteria, managed care requirements for inpatient and outpatient authorization and advocates on behalf of the patient to secure coverage for needed services
  • Completes pre and re-certifications for inpatient and outpatient services. Reports appropriate denial, and authorization information to designated resource.
  • Actively communicates with interdisciplinary team to acquire pertinent information and give updates on authorizations.
  • Participate in treatment teams to ensure staff have knowledge of coverage and to collect information for communication with agencies.
  • Works with DON to ensure documentation requirements are met.
  • Ensure appeals are completed thoroughly and on a timely basis.
  • Interface with managed care organizations, external reviews, and other payers.
  • Communicate with physicians to schedule peer to peer reviews.
  • Accurately report denials.

What we offer:

Fundamental to providing great care is supporting and rewarding our team. In addition to your base compensation, this position also offers:

  • Comprehensive medical, dental, and vision plans, plus flexible-spending and health- savings accounts
  • Competitive paid time off and extended illness bank package for full-time employees
  • Income-protection programs, such as life, accident, critical-injury insurance, short- and long-term disability, and identity theft coverage
  • Tuition reimbursement, loan assistance, and 401(k) matching
  • Employee assistance program including mental, physical, and financial wellness
  • Professional development and growth opportunities

Qualifications and requirements:

  • Education: Bachelor's degree required. Master's degree preferred.
    Experience: Previous utilization review experience in a psychiatric healthcare facility preferred.
    License: Current unencumbered clinical license strongly preferred.

EEOC Statement

Valley Springs Behavioral Hospital is an Equal Opportunity Employer. Valley Springs Behavioral Hospital is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.

Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.We employ and provide care to people from all walks of life. We are committed to promoting healing, providing hope, preserving dignity and producing value with an inclusive workforce in which diversity is leveraged, respected, and reflective of the patients, family members, customers and team members we serve.

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Hours and flexibility

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About LifePoint Health

Sourced by ZipRecruiter

Lifepoint Health serves patients, clinicians, communities and partners across the healthcare continuum. Our diversified healthcare delivery network extends from coast to coast, consisting of community hospitals, rehabilitation and behavioral health hospitals, and additional sites of care.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Brentwood, TN, US

Year founded

1999

Social media

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