Utilization Review Coordinator Jobs
Utilization Review Coordinator jobs are open across health systems, managed care organizations, insurance carriers, and specialty clinics, from entry-level to senior coordinator and clinical review lead, with specializations in prior authorization, concurrent review, and discharge planning. See the openings below and apply to the ones that match your experience.
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SUMMARY:
The Authorization Nurse will oversee the processing of assigned authorizations for participant care, supplies, and other related needs. This will include but not be limited to primary responsibility for Emergency Room and Hospital Admission authorizations as well as oversight of accurate completion of all other types in conjunction with clinical and supportive staff.
SPECIFIC DUTIES AND FUNCTIONS:
- Enter authorizations for participants seen in Emergency Departments and/or Admitted to the Hospital, including Observation stays; complete authorization to include all required information (i.e. discharge date, diagnosis, discharge location).
- Coordinate authorization information for all participant care needs with interdisciplinary team (IDT) members ensuring completeness of all required information.
- In tandem with Authorization Coordinator, monitor all participant authorizations in EMR for accuracy and correct information.
- Assess need and provide education to IDT staff regarding authorization processing and management to improve compliance where required.
- Recommend workflow modifications/changes to improve PACE Southeast MI authorization management in terms of both efficiency and quality.
- Audit EMR (currently TruChart) for authorization status, notifying individuals and leadership of any trends or issues relating to timeliness, error rates, or similar quality issues.
- Assign specific tasks to support audit needs and action plans to Authorization Coordinator.
- Present audit findings to key Leadership Team members on a regular basis plus as requested, participating as a member of the PACE Southeast MI Quality Improvement Team.
- Other duties as assigned.
KNOWLEDGE, SKILLS AND ABILITIES:
- Registered Nurse in State of MI with unencumbered license, BSN preferred;
- Minimum 2 years’ experience in a managed care environment, preferably in a utilization related role;
- Must have one year of experience with a frail, elderly population
WORK ENVIRONMENT:
- Professional office environment
- Occasional interaction with participants with risk of exposure to communicable diseases
SUMMARY:
The Authorization Nurse will oversee the processing of assigned authorizations for participant care, supplies, and other related needs. This will include but not be limited to primary responsibility for Emergency Room and Hospital Admission authorizations as well as oversight of accurate completion of all other types in conjunction with clinical and supportive staff.
SPECIFIC DUTIES AND FUNCTIONS:
- Enter authorizations for participants seen in Emergency Departments and/or Admitted to the Hospital, including Observation stays; complete authorization to include all required information (i.e. discharge date, diagnosis, discharge location).
- Coordinate authorization information for all participant care needs with interdisciplinary team (IDT) members ensuring completeness of all required information.
- In tandem with Authorization Coordinator, monitor all participant authorizations in EMR for accuracy and correct information.
- Assess need and provide education to IDT staff regarding authorization processing and management to improve compliance where required.
- Recommend workflow modifications/changes to improve PACE Southeast MI authorization management in terms of both efficiency and quality.
- Audit EMR (currently TruChart) for authorization status, notifying individuals and leadership of any trends or issues relating to timeliness, error rates, or similar quality issues.
- Assign specific tasks to support audit needs and action plans to Authorization Coordinator.
- Present audit findings to key Leadership Team members on a regular basis plus as requested, participating as a member of the PACE Southeast MI Quality Improvement Team.
- Other duties as assigned.
KNOWLEDGE, SKILLS AND ABILITIES:
- Registered Nurse in State of MI with unencumbered license, BSN preferred;
- Minimum 2 years’ experience in a managed care environment, preferably in a utilization related role;
- Must have one year of experience with a frail, elderly population
WORK ENVIRONMENT:
- Professional office environment
- Occasional interaction with participants with risk of exposure to communicable diseases
Utilization Review Coordinator Jobs by Experience Level
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Find JobsUtilization Review Coordinator Job Market
Who's Hiring
Top Industries Hiring
- Healthcare & Medical Services
- Insurance
- Education
- Human Resources
- Science & Research
What Employers Look For
The qualifications that appear most often in utilization review coordinator jobs.
- Active RN, LPN, or related clinical license required by most employers
- Working knowledge of InterQual or MCG clinical criteria for review decisions
- Experience with prior authorization, concurrent review, or discharge planning workflows
- Familiarity with ICD-10 coding and medical terminology across care settings
- Proficiency with electronic health record systems and payer portals
- CPUR, CMCN, or similar utilization management certification preferred for senior roles
Tips for Your Utilization Review Coordinator Job Search
Tailor your resume for UR-specific language
Hiring managers scan for terms like prior authorization, InterQual, MCG criteria, and concurrent review. If your experience includes these, use the exact phrasing from the job posting so your resume clears applicant tracking systems before a human ever reads it.
Highlight your clinical credentials upfront
Many utilization review coordinator postings screen first for licensure, so put your RN, LPN, or LCSW credentials directly after your name. If you hold a CPUR or CMCN certification, list it in the same line so it's visible immediately.
Apply early to roles that fit
Migrate Mate lists utilization review coordinator openings from across the United States in one place, so you can find roles that match and apply directly to each listing.
Target postings by payer type, not just title
Your experience with commercial insurance, Medicare Advantage, or Medicaid managed care matters to employers. Filter or search by payer type when possible, and name the specific payers you've worked with in your resume summary to signal relevant expertise fast.
Prepare scenario answers about denial decisions
Interviewers frequently ask how you handle a denial recommendation when a provider pushes back. Prepare a concise example that shows you applied clinical criteria objectively, documented your rationale clearly, and communicated the outcome professionally to all parties involved.
Negotiate by citing turnaround time performance
If you consistently met or exceeded CMS or payer-required review turnaround times, that's a concrete performance metric you can reference when discussing compensation. It demonstrates you understand compliance pressures and deliver results under regulatory deadlines.
Utilization Review Coordinator Jobs: Frequently Asked Questions
Which companies are hiring the most utilization review coordinators?
The most active employers for utilization review coordinators right now are UT Southwestern Medical Center, Providence, and MedStar Health, and the most openings are in California, Texas, and Ohio, based on current listings on Migrate Mate as of November 2026. Health systems, managed care organizations, and third-party review companies consistently post the highest volumes of openings.
How many utilization review coordinator jobs are remote?
About 73% of utilization review coordinator openings are fully remote or hybrid as of November 2026, reflecting strong demand for reviewers who can work independently with payer portals and EHR systems. Prior authorization and telephonic concurrent review roles tend to have the highest share of remote-eligible positions within the specialty.
How do you become a utilization review coordinator?
Start by earning a clinical license, most commonly as an RN or LPN, since the majority of employers require active licensure. Gain direct patient care experience in an acute, managed care, or insurance setting to build familiarity with care criteria and documentation standards. From there, pursue a role in case management or prior authorization to develop review skills, then target utilization review coordinator postings directly. Earning a CPUR or CMCN certification strengthens your candidacy for more competitive roles.
Can I get a utilization review coordinator job with limited experience?
Yes, some employers hire candidates with strong clinical backgrounds but little formal utilization review experience, particularly for entry-level or training-track coordinator roles. Emphasize any exposure to insurance authorization, discharge planning, or case management in your application. Knowing how to read InterQual or MCG criteria, even from self-study, signals readiness. Smaller regional health plans and third-party review vendors are often more open to developing candidates than large national payers.
What does the utilization review coordinator interview process look like?
Most employers start with a phone or video screen conducted by a recruiter or nurse manager to confirm licensure, clinical background, and availability. A second round typically involves a clinical or operations lead who asks scenario-based questions about applying criteria, handling provider disagreements, and managing turnaround time under compliance deadlines. Some employers add a brief written or case-review exercise to assess documentation quality and clinical reasoning before extending an offer.
Where can I find and apply to utilization review coordinator jobs?
You can find and apply to utilization review coordinator jobs on Migrate Mate, which lists current openings from across the United States in one place. Search for roles that match your clinical background, licensure, and preferred work setting, then apply directly to each listing that fits.
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