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Dental Utilization Management Manager Jobs (NOW HIRING)

Wellpath

Director Utilization Mgmt

Lemoyne, PA

Overview The Medical Director of Utilization Management leads and oversees utilization review, case management, quality improvement, and related policy and practice initiatives within their assigned ...

Summit BHC

The Utilization Management Manager is responsible for the overall management of the UM department by leading and facilitating review of assigned admissions, continued stays, utilization practices and ...

UHS

Utilization Management Specialist

Plymouth, IN

Excellent Medical, Dental, Vision and Prescription Drug Plan * 401(K) with company match and ... Certification in Utilization Management a plus. * Knowledge of regulatory and insurance required.

UHS

Utilization Management Specialist

Plymouth, IN · On-site

Excellent Medical, Dental, Vision and Prescription Drug Plan * 401(K) with company match and ... Certification in Utilization Management a plus. * Knowledge of regulatory and insurance required.

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Dental Utilization Management Manager information

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$39K

$91K

$167.5K

How much do dental utilization management manager jobs pay per year?

As of Jun 12, 2026, the average yearly pay for dental utilization management manager 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 some of the common challenges faced by a Dental Utilization Management Manager, and how can they be addressed?

Dental Utilization Management Managers often encounter challenges such as balancing cost containment with quality patient care, staying updated on evolving dental guidelines, and effectively communicating with both dental providers and insurance teams. Addressing these challenges typically involves staying current with industry best practices, fostering collaborative relationships with stakeholders, and implementing clear review protocols to ensure consistency and fairness in utilization decisions. Strong analytical and leadership skills are essential for navigating these complexities and ensuring both compliance and high standards of care.

What are the key skills and qualifications needed to thrive as a Dental Utilization Management Manager, and why are they important?

To thrive as a Dental Utilization Management Manager, you need a deep understanding of dental procedures, insurance policies, and utilization review, often supported by a dental degree or certification and experience in managed care. Familiarity with claims processing systems, dental coding (such as CDT codes), and utilization management software is typically required. Strong analytical abilities, attention to detail, leadership, and effective communication are standout soft skills in this role. These competencies ensure accurate benefit determinations, regulatory compliance, and high-quality service for both providers and members.

What does a Dental Utilization Management Manager do?

A Dental Utilization Management Manager oversees the evaluation of dental treatment requests to ensure they are medically necessary and meet established clinical guidelines. They review claims, coordinate with dental providers, manage a team of utilization review specialists, and help implement policies to improve efficiency and cost-effectiveness in dental benefit programs. Their goal is to ensure quality patient care while controlling costs for dental insurance plans.

What is the difference between Dental Utilization Management Manager vs Dental Utilization Review Coordinator?

AspectDental Utilization Management ManagerDental Utilization Review Coordinator
CredentialsTypically requires a dental or healthcare-related degree and management experienceUsually requires dental assisting, dental hygiene, or healthcare certification
Work EnvironmentSupervises teams, manages policies, and oversees utilization processesPerforms case reviews, evaluates treatment plans, and communicates with providers
Employer & Industry UsageFound in insurance companies, healthcare organizations, and dental benefit plansCommon in insurance companies, dental clinics, and healthcare providers

The Dental Utilization Management Manager oversees the utilization review process, manages teams, and develops policies, while the Dental Utilization Review Coordinator focuses on case-by-case reviews and provider communication. Both roles are essential in dental insurance and healthcare settings but differ mainly in scope and responsibilities.

More about Dental Utilization Management Manager jobs
What cities are hiring for Dental Utilization Management Manager jobs? Cities with the most Dental Utilization Management Manager job openings:
What are the most commonly searched types of Dental Utilization Management jobs? The most popular types of Dental Utilization Management jobs are:
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What job categories do people searching Dental Utilization Management Manager jobs look for? The top searched job categories for Dental Utilization Management Manager jobs are:
Dental Utilization Management Manager jobs near you
Infographic showing various Dental Utilization Management Manager job openings in the United States as of June 2026, with employment types broken down into 1% As Needed, 89% Full Time, 9% Part Time, and 1% Contract. Highlights an 92% In-person, 1% Hybrid, and 7% Remote job distribution, with an average salary of $91,011 per year, or $43.8 per hour.
Utilization Management Manager-Utilization Mgmt- Days - FT

Utilization Management Manager-Utilization Mgmt- Days - FT

Memorial Health System

Gulfport, MS • On-site

Full-time

Posted 2 days ago

Job description

Job Description
Oversee the management of patient care utilization, ensuring appropriate healthcare services are provided while optimizing resource use. This individual will be responsible for leading a team of nurses who review medical necessity, appropriateness and efficiency of healthcare services. Ensure compliance with regulatory requirements and maintain high standards of care.
Responsibilities
  • Supervise and lead the UM nursing team and Pre-Certification Specialists, ensuring the review of patient cases for appropriate medical necessity and care protocols
  • Develop, implement and maintain UM policies and procedures in accordance with healthcare regulation and organizational standards
  • Conduct regular training and provide ongoing support for UR team to improve knowledge and performance
  • Collaborate with physicians, other healthcare providers and insurance companies to review and improve treatment plans. Ensure all services are medically necessary and cost effective
  • Evaluate and analyze healthcare utilization trends, identify opportunities for improvement and solutions to improve outcome
  • Monitor and ensure compliance with regulatory requirements including Medicare, Medicaid and other payer policies
  • Prepare and present reports on utilization metrics, case reviews and outcomes to administration leadership groups
  • Resolve complex case issues and provide guidance on challenging utilization decisions
  • Ensure accurate documentation of all UM reviews, ensuring compliance with internal and external audit
  • Foster effective communication between departments, stakeholders and healthcare professionals

Qualifications
Education Requirements
Required: Bachelor Degree
  • Bachelor of Science in Nursing, with an active unrestricted license

Preferred: Master's Degree
  • Nursing or other clinical discipline, Health Administration, Finance, Business Administration, or a related field

License or Certification Requirements
Required: License
  • Nursing degree (RN, BS, BSN, or advanced degree) and unrestricted active nursing license

Experience Requirements
Required: 5 years
  • Nursing experience with at least 2 years in Utilization Management or case management role

Preferred: 2 years
  • Leadership or management experience in nursing or related field

Core Competencies
Knowledge:
  • In depth knowledge of healthcare utilization management processes, medical terminology and clinical guidelines
  • Familiarity with payer requirements and regulation including Medicare, Medicaid and private insurers
  • Working knowledge of applications that are used to enhance utilization management based on evidenced based approach and guidelines
  • Strong knowledge of Microsoft Office applications

Skills:
  • Analytical Skills: The ability to analyze large data sets, determine trends, synthesize results, and deliver prioritized details through effective reporting
  • Communication Skills: Strong communication and interpersonal skills for effective collaboration and education
  • Problem-Solving Skills: The capacity to understand issues, derive many potential solutions, troubleshoot discrepancies, and understand systematic approaches to problem resolution

Abilities:
  • Attention to Detail: Precision is essential when reporting critical analysis to inform decision-making and operational change
  • Time Management: Managing multiple tasks and deadlines while prioritizing work is essential in a fast-paced healthcare environment
  • Technology Proficiency: Beyond EHR systems, familiarity with various billing software and technology tools

Work Environment: This position may involve working in a variety of clinical and administrative settings, requiring adaptability and a proactive approach to problem-solving.
Physical Demands: Frequent reaching, sitting, walking, and standing may be required. No special coordination beyond that used for normal mobility and handling of everyday objects and materials is needed to perform the job.

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