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Utilization Review Coordinator Jobs in Springfield, MA

MiraVista

Social Worker, Full Time Days

Holyoke, MA · On-site

... utilization review and provide liaison services to patients and their family/guardians, the hospital, and outside community agencies and programs as needed for care coordination. * You will work ...

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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.

RN Case Manager in East Glastonbury, CT

Vivian Health

Glastonbury, CT • On-site

Other

Posted 16 days ago

Job description

Registered Nurse (RN) Case Manager

Location Detail: 71 Haynes Street (10627)

Shift Detail: Day shift and weekends.

Work where every moment matters. 
Every day, over 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here.  We invite you to become part of Connecticut’s most comprehensive healthcare network as a Clinical Nurse Educator.

The Greater Manchester Region has approximately 2,500 employees. It includes Manchester Memorial Hospital, a 249-bed community hospital, Rockville General, a campus of Manchester Memorial Hospital, a 102-bed facility, a large multispecialty provider group and visiting nurse services. The Greater Manchester Region serves a region of 300,000 people in 19 towns.

POSITION SUMMARY:

The Care Manager provides a link between provider and payer organizations, physicians and the community in the transition of patient care through the health care system. Monitors all admissions for the appropriateness of observation services or inpatient hospitalization, according to InterQual criteria. Utilizing the nursing process, identifies patients with discharge planning needs and coordinates necessary services in the home or nursing facility setting. Coordinates patient care by using independent nursing judgment and working collaboratively with the interdisciplinary team. Communicates, as appropriate, the patient’s clinical condition and care needs. Demonstrates knowledge of the principles of growth and development over the life span and the skills necessary to provide age appropriate care to the patient population served. Professional knowledge and judgment will be utilized when guidelines are unavailable or inappropriate for a given situation. Promotes the profession of nursing and professional practice through collegial support and interactions. Is primarily assigned to one hospital, but will be required to provide coverage at the other hospital as needed. Reports to the Manager of Care Management.

Qualifications

EDUCATION/CERTIFICATION

· Graduate of an accredited school of Nursing

· Baccalaureate degree in an applicable field required.

· Must have a current license as a Registered Nurse in the State of Connecticut.

· Professional certification in case management or clinical specialty is preferred.

EXPERIENCE

· Must have at least five (5) years of nursing experience in a medical surgical acute care setting

· Additional experience in case management, home care, and utilization review/management is preferred.

COMPETENCIES

· Requires good analytical, organizational and interpersonal skills as well as the ability to communicate effectively in English, both verbally and in writing.

· A basic proficiency in personal computers is required.

We take great care of careers.

With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge – helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving colleagues-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this isyour moment.

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