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Utilization Jobs (NOW HIRING)

The Utilization Specialist will work closely with the clinical teams, Director of Patient Services, and external stakeholders to support the delivery of high-quality care in alignment with the ...

The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...

The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...

Utilization Specialist

Los Angeles, CA · On-site

$64K - $75K/yr

The Utilization Specialist will work closely with the clinical teams, Director of Patient Services, and external stakeholders to support the delivery of high-quality care in alignment with the ...

Utilization Management

Houston, TX · On-site

$38 - $40.86/hr

Behavioral Health Utilization Review RN HealthCare Support is actively seeking a Remote BH Utilization Review RN to fill an opening with a Managed Care Company . Daily Responsibilities for Remote BH ...

PR · On-site

Proactively monitor utilization of services for patients to optimize reimbursement for the facility. Responsibilities ESSENTIAL FUNCTIONS: * Act as liaison between managed care organizations and the ...

Utilization Specialist page is loaded## Utilization Specialistlocations: The Pavilion at Williamsburg Placetime type: Full timeposted on: Posted Todayjob requisition id: JR124748Utilization ...

Utilization Specialist | The Pavilion at Williamsburg Place | Williamsburg, Virginia About the Job: The Utilization Specialist is responsible for reviewing of assigned admissions, continued stays ...

Utilization Tech/Nurse M-F 1st shift, 32 biweekly hours 8-4:30 Clinical background preferred About VGH Virginia Gay Hospital, established in Vinton in 1923, is an independent, nonprofit critical ...

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Utilization information

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How much do utilization jobs pay per hour?

As of Sep 8, 2026, the average hourly pay for utilization in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What is a utilization specialist?

Utilization specialists are professionals who review and evaluate the necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities. They work closely with healthcare providers, insurance companies, and patients to ensure that care is delivered according to established guidelines and that resources are used effectively. Their goal is to help manage costs while ensuring patients receive the appropriate level of care.

What are some of the common challenges faced by utilization review specialists when assessing medical necessity of services?

Utilization Review Specialists often encounter the challenge of balancing patient advocacy with cost-effective care. They must stay updated on evolving insurance policies and clinical guidelines, which can be complex and change frequently. Additionally, coordinating with physicians and healthcare staff to obtain necessary documentation and clarifying treatment plans can be time-consuming. Strong communication skills and attention to detail are essential to ensure timely and accurate reviews, while also maintaining positive working relationships with clinical teams.

What are the key skills and qualifications needed to thrive as a utilization review specialist, and why are they important?

To thrive as a Utilization Review Specialist, you need a background in healthcare (often as an RN or LPN/LVN), strong analytical skills, and knowledge of insurance and medical necessity criteria. Familiarity with utilization management software, ICD-10/CPT coding, and regulatory guidelines like Medicare and Medicaid is typically required. Excellent attention to detail, critical thinking, and effective communication skills set top performers apart in this role. These abilities are crucial to accurately evaluating patient care needs, ensuring regulatory compliance, and optimizing resource use within healthcare organizations.

What is the difference between Utilization vs Resource Coordinator?

AspectUtilizationResource Coordinator
Primary FocusMeasuring and optimizing how staff time is usedManaging and assigning resources for projects
Required CredentialsOften no specific credentials, but industry experience helpsTypically requires organizational or project management skills
Work EnvironmentCorporate, healthcare, or consulting firmsProject teams, staffing agencies, or departments
Common UsageTracking staff utilization ratesAllocating resources to projects or tasks

Utilization focuses on measuring how effectively staff time is used, often to improve productivity. Resource Coordinator involves actively managing and assigning resources to ensure project needs are met. While related, utilization is more about analysis, and resource coordination is about execution and management.

How to become a utilization reviewer?

To become a utilization reviewer, candidates typically need a background in healthcare, nursing, or a related field, along with knowledge of medical coding and insurance policies. Relevant certifications such as Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS) can enhance job prospects. Strong analytical skills and attention to detail are essential for reviewing medical records and determining appropriate service utilization.
More about Utilization jobs

What cities are hiring for Utilization jobs?

Cities with the most Utilization job openings:

What are the most commonly searched types of Utilization jobs?

The most popular types of Utilization jobs are:

What states have the most Utilization jobs?

States with the most job openings for Utilization jobs include:

Infographic showing various Utilization job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 87% Full Time, 9% Part Time, and 2% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Coordinator

Aveanna Healthcare

Culver City, CA • On-site

Other

Re-posted 18 days ago


Aveanna Healthcare rating

6.7

Company rating: 6.7 out of 10

Based on 202 frontline employees who took The Breakroom Quiz

65th of 247 rated social care providers


Job description

Additional Posting Information
Hybrid
Overview
Position Overview
The Utilization Coordinator is responsible for ensuring that clients and their families are fully supported in accessing and utilizing their approved services through the Regional Center. The role focuses on activating inactive cases, identifying and addressing barriers to service utilization, and collaborating closely with families, care providers, and Regional Center staff to facilitate successful service delivery. The Utilization Coordinator also contributes to special projects such as identifying and resolving unbilled services and supporting the development and implementation of new services. The Utilization Coordinator is an important contributor to the Aveanna team, helping to increase service utilization and drive census growth.
Essential Functions
Act as a liaison between all departments to address concerns, provide updates, and facilitate smooth interactions with families
Generate and analyze SQL reports to identify trends, discrepancies and issues related to service utilization
Utilize AveannaCare system to generate and analyze reports, identifying any discrepancies or inefficiencies in service utilization
Develop a comprehensive understanding of the services offered by the regional center to effectively identify and address utilization issues
Follow up with families and provide subsequent follow-ups for up to 12 months
Collaborate with relevant teams to identify and assist in the resolution of unbilled issues, ensuring accurate and timely billing for services provided
Assist in the coordination and setting up of new services, ensuring all processes are executed smoothly
Maintain effective communication with all organizational levels, ensuring clarity of information, fostering collaboration, and facilitating prompt decision-making
Performs other duties as assigned or needed
Requirements
Bachelor's degree is preferred, but not required
Bilingual required, Spanish preferred
Minimum of one year of customer service experience within the last four years
Ability to work effectively with others
Excellent interpersonal skills; self-driven, motivated and results oriented
Must be able to problem solve and apply creative solutions
Strong analytical and judgment skills
Intermediate computer skills using Microsoft Windows, Word, Excel and ability to be trained on Aveanna's proprietary software programs
Ability to successfully handle multiple tasks simultaneously; strong organizational skills
Thrive in a fast-paced environment
Other Skills/Abilities
Ability to adhere to confidentiality standards and professional boundaries at all times.
Quick-thinking and astute decision-making skills
Attention to detail
Ability to effectively manage time and meet deadlines
Effective problem-solving and conflict resolution skills
Excellent organizational and communication skills
Ability to remain calm and professional in stressful situations
Strong commitment to excellence
Physical Requirements
Must be able to speak, write, read, and understand English
Occasional lifting, caring, pushing and pulling of up to 25 pounds
Prolonged walking, standing, bending, kneeling, reaching, twisting
Must be able to sit and climb stairs
Must have visual and hearing acuity
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Vaccination Requirements
As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.
This is a Hybrid position; therefore, candidates must have a reliable high-speed internet connection (Ethernet cable) to support video conferencing, system access, and daily communication.
Join a Company That Puts People First!
At Aveanna, we're proud to foster a workplace culture that celebrates diversity, encourages connection, and supports our team members every step of the way. Here's what sets us apart:
Award-Winning Culture
- Ranked the #1 company to work for in Georgia in 2024 by U.S. News & World Report.
Employee Connection & Support
- Aveanna Connection Groups: Employee-led groups where shared identities and experiences create spaces for connection, collaboration, and support.
- Aveanna Social Circles: Join groups based on your interests, like books, music, or movies, to build camaraderie and lasting friendships.
- Aveanna Employee Relief Fund: A resource to help our team members through unexpected hardships, because we're stronger together.
Inclusive Learning Environment
- We believe in growing together. Our inclusive learning sessions are open to all employees, fostering collaboration and shared success.
Commitment to Community
- Every year, we dedicate a day to giving back through our Annual Service Day, making a meaningful impact in the communities we serve.
Headhunters and recruitment agencies may not submit resumes/CVs through this website or directly to managers. Aveanna does not accept unsolicited headhunter and agency resumes, and will not pay fees to any third-party agency or company that does not have a signed agreement with Aveanna.

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About Aveanna

Sourced by ZipRecruiter

Aveanna Healthcare is one of the nation's leading providers of pediatric and adult homecare in the nation. We lead with clinical quality and compassion, delivering care in over 200 locations in 23 states. While we have a national presence, we are very much a local provider in each community we serve. Our stated mission is to revolutionize the way pediatric healthcare is delivered, one patient at a time, and we hope you will help us fulfill that mission by joining the 30,000 nurses who already call Aveanna home. Apply today.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Atlanta, GA, US