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Utilization Jobs (NOW HIRING)

Dungarvin

Utilization Coordinator

Long Beach, CA · On-site

$22.50/hr

As a Utilization Coordinator , you will support daily healthcare operations by managing client scheduling, authorization tracking, caregiver communication, and high-volume data entry. This role plays ...

Summit BHC

Utilization Specialist

Champaign, IL

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

UHS

UTILIZATION COORDINATOR

Memphis, TN · On-site

Responsibilities Utilization Management Coordinator Compass Intervention Center is seeking a dynamic and talented Utilization Management Coordinator. Our mission is to provide superior behavioral ...

Dungarvin, Inc.

Utilization Coordinator

Long Beach, CA

$22.50/hr

As a Utilization Coordinator, you will support daily healthcare operations by managing client scheduling, authorization tracking, caregiver communication, and high-volume data entry. This role plays ...

Seneca Health

Utilization Nurse

Salamanca, NY · On-site

Reviews hospital treatment plans and utilization of services for medical necessity, appropriateness, and alignment with payer, regulatory, and organizational guidelines including PRC authorization ...

Summit BHC

Utilization Specialist

Williamsburg, VA · On-site

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

Acadia Healthcare

Utilization Specialist

Danville, PA · On-site

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

Seneca Health

Utilization Nurse

Irving, NY · On-site

Reviews hospital treatment plans and utilization of services for medical necessity, appropriateness, and alignment with payer, regulatory, and organizational guidelines including PRC authorization ...

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Utilization information

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$21

$42

$68

How much do utilization jobs pay per hour?

As of May 31, 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 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 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 utilization specialists?

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 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.

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:
Utilization jobs near you
Infographic showing various Utilization job openings in the United States as of May 2026, with employment types broken down into 1% As Needed, 86% Full Time, 11% Part Time, and 2% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
RN, Utilization Management | Utilization Management

RN, Utilization Management | Utilization Management

UF Health

Saint Augustine, FL

Other

Posted 9 days ago

Job description

Overview
Make an impact by supporting the right care at the right time through utilization management excellence.
Work Style: Onsite
Location: St. Agustine, FL
FTE: Full-Time (1.0 FTE)
Schedule: Monday - Friday, 3:00 PM - 11:00 PM
Plays a critical role in evaluating patient medical records to ensure the necessity and appropriateness of healthcare services. Involves coordinating with healthcare providers to maintain compliance with utilization management guidelines and optimizing treatment plans for effective patient care and resource utilization. Requires clear communication of authorization decisions and ongoing monitoring to support timely discharge planning. Analyzes utilization data to identify trends and collaborates with interdisciplinary teams to enhance care coordination while ensuring accurate documentation and regulatory compliance.
Responsibilities
Key Responsibilities
  • Evaluates patient medical records to determine the medical necessity and appropriateness of healthcare services.
  • Coordinates with healthcare providers and care teams to ensure compliance with utilization management guidelines and payer requirements.
  • Supports effective treatment planning, patient care coordination, and appropriate resource utilization.
  • Communicates authorization decisions and utilization determinations while supporting timely discharge planning efforts.
  • Analyzes utilization management data and trends to identify opportunities for improved care coordination and operational efficiency.
  • Collaborates with interdisciplinary teams to ensure accurate documentation, regulatory compliance, and quality patient outcomes.
Qualifications
Education & Licensure
  • Registered Nurse (RN) with a current Florida nursing license required.
Experience & Skills
  • Minimum of three (3) years of experience in utilization review, utilization management, or case management required.
  • Knowledge of healthcare utilization guidelines, payer requirements, and regulatory compliance standards.
  • Experience evaluating medical necessity, treatment plans, and appropriate levels of care.
  • Strong communication and collaboration skills related to authorization determinations and care coordination.
  • Demonstrated ability to analyze utilization data, identify trends, and support patient care and discharge planning initiatives.

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