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Dental Utilization Management Jobs (NOW HIRING)

Intus, Inc

Utilization Management Nurse

$80K - $95K/yr

Role Overview The Utilization Management Nurse plays a critical role in ensuring high-quality, cost ... Comprehensive benefits including health, dental, and vision insurance. * A collaborative, inclusive ...

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Dental Utilization Management information

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$91K

$167.5K

How much do dental utilization management jobs pay per year?

As of Jul 20, 2026, the average yearly pay for dental utilization management in the United States is $91,011.00, according to ZipRecruiter salary data. Most workers in this role earn between $59,500.00 and $109,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Dental Utilization Management position, and why are they important?

Excelling in Dental Utilization Management requires a deep understanding of dental procedures, insurance policies, and clinical guidelines, often supported by a background in dental hygiene, dentistry, or healthcare administration. Familiarity with dental claims software, electronic health records (EHR), and relevant certifications such as Registered Dental Hygienist (RDH) or Certified Professional in Healthcare Quality (CPHQ) is highly valuable. Strong analytical thinking, communication, and attention to detail help professionals effectively review cases, collaborate with providers, and ensure accurate claims processing. These competencies are vital for balancing patient care quality, regulatory compliance, and cost-effectiveness within dental insurance programs.

What does a typical day look like for a professional in Dental Utilization Management?

In Dental Utilization Management, your day typically involves reviewing dental insurance claims, applying clinical guidelines to determine coverage, and communicating with dental providers for additional information or clarification. You may use specialized software and medical records systems to evaluate treatment plans and ensure compliance with policy criteria. Collaboration with other utilization management specialists, claims adjusters, and sometimes members of clinical review teams is common. The role demands a blend of independent case analysis and teamwork to support fair and efficient decision-making, making the work both varied and rewarding.

What is a Dental Utilization Management job?

A Dental Utilization Management job involves reviewing and analyzing dental treatment plans and insurance claims to ensure they meet clinical guidelines and cost-effectiveness standards. Professionals in this role assess the necessity and appropriateness of dental procedures, working closely with providers and insurance companies to maintain quality patient care while managing costs. They may also help develop policies, conduct audits, and provide education on best practices in dental care utilization.

More about Dental Utilization Management jobs
What are the most commonly searched types of Dental Utilization Management jobs? The most popular types of Dental Utilization Management jobs are:
What states have the most Dental Utilization Management jobs? States with the most job openings for Dental Utilization Management jobs include:
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Dental Utilization Management jobs near you
Infographic showing various Dental Utilization Management job openings in the United States as of July 2026, with employment types broken down into 97% Full Time, and 3% Part Time. Highlights an 89% In-person, and 11% Remote job distribution, with an average salary of $91,011 per year, or $43.8 per hour.
Utilization Management Nurse

Utilization Management Nurse

Intus, Inc

Remote

$80K - $95K/yr

Full-time

Medical, Dental, Vision

Posted yesterday

Job description

About IntusCare
IntusCare is the only end-to-end ecosystem built specifically to help Programs of All-Inclusive Care for the Elderly (PACE) programs deliver exceptional care, strengthen financial performance, and stay compliant. IntusCare replaces outdated technology and manual workarounds with purpose-built solutions for care coordination, risk adjustment, population health, and utilization management. IntusCare empowers teams to take control of their operations and improve outcomes for dual-eligible seniors - some of the most socially vulnerable and clinically complex individuals in the US healthcare system.
Role Overview
The Utilization Management Nurse plays a critical role in ensuring high-quality, cost-effective, and compliant care for PACE participants supported by IntusCare. This individual partners closely with PACE Interdisciplinary Teams, Medical Directors, and provider networks to review service utilization, guide care decisions and support timely, appropriate transitions across care settings. Blending clinical expertise with analytical thinking, the Utilization Management Nurse ensures services are medically necessary, aligned with care plans and consistent with PACE regulations and best practices. This role is essential to maintaining program integrity, improving participant outcomes and supporting the delivery of coordinated, value-based care.
Responsibilities
  • Rigorous adherence to PACE program service authorization policies, ensuring that participant care and related claims are:
    • Reasonable and necessary for diagnosis or treatment and consistent with PCP coordination decisions.
    • In accordance with accepted medical standards and consistent with the participant care needs including level of care and advanced care planning principles.
  • Active involvement in various aspects of the utilization management process, including:
    • Concurrent review of all hospital admissions (observation and inpatient) with the Interdisciplinary Team driving efficient and timely transitions of care, retrospective review of inpatient admissions under 48 hours, and claims submitted inconsistent with the service authorization.
    • Concurrent review of all subacute and SNF admissions with the Interdisciplinary Team driving efficient and timely discharge plans and transitions of care.
    • Coordination and review of all other services delivered by contracted providers and identified by the PACE program assuring consistency with Interdisciplinary Team service authorization, care plans, and PCP coordination decisions.
  • Employ effective use of knowledge, critical thinking, and skills to:
    • Advocate quality care and enhanced quality of life
    • Advocate decreased hospital stay when appropriate
    • Maintain accurate records of all patient related interactions
  • Appeal Management - In cases of claim rejection, the Intus Care Utilization Management Nurse will lead the provider appeals process. Responsibilities Include:
    • Comprehensive review of provider network appeals.
    • Collaboration with the PACE Program's Medical Director to review and respond to appeal requests, ensuring issuance of a written determination consistent with the PACE program policies.

Qualifications
  • 3 to 5 years of utilization management experience.
  • Current RN license
  • Proven experience working in risk based integrated models of care.
  • Ability to use data to drive decisions and collaboration with internal and external stakeholders.
  • Strong strategic thinking, problem solving, and decision making skills.
  • Excellent communication and leadership abilities, capable of motivating and guiding teams toward timely and efficient care management strategies

What We Offer
  • A chance to be a part of a trailblazing team in healthcare technology.
  • Competitive salary and equity package.
  • Comprehensive benefits including health, dental, and vision insurance.
  • A collaborative, inclusive, and dynamic work environment.
  • Opportunities for professional growth and development

Compensation: The salary range for this role is $80K-$95K. We expect the ideal candidate to fall near the midpoint of this range, though final compensation will be determined based on experience, skills, and organizational needs.
Work location: This is a fully remote role based in the United States.
Sponsorship: This position is not eligible for sponsorship.

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