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Dental Utilization Management Jobs (NOW HIRING)

Humana

Manager, Utilization Management Nursing

Lead and oversee Utilization Management Assistant Supervisors supporting LTSS populations ... Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings ...

Humana

Utilization Management Nurse

The Utilization Management Nurse 2 work assignments are varied and frequently require ... Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings ...

Humana

Utilization Management Nurse

The Utilization Management Nurse 2 work assignments are varied and frequently require ... Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings ...

Oak St. Health

Utilization Management Nurse Consultant

$32.01 - $68.55/hr

Registered Nurse (RN) - Utilization Management Are you an experienced RN looking to leverage your ... The benefits for this position include medical, dental, and vision coverage, paid time off ...

Oak St. Health

Utilization Management Nurse Consultant

$32.01 - $68.55/hr

CVS Health Utilization Management Position We're building a world of health around every individual ... The benefits for this position include medical, dental, and vision coverage, paid time off ...

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Dental Utilization Management information

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$39K

$91K

$167.5K

How much do dental utilization management jobs pay per year?

As of Sep 3, 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 is dental utilization management?

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.

What does a dental utilization management professional do?

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 are the key skills and qualifications needed for dental utilization management?

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.

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:

What job categories do people searching Dental Utilization Management jobs look for?

The top searched job categories for Dental Utilization Management jobs are:

Dental Utilization Management jobs near you
Infographic showing various Dental Utilization Management job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 75% In-person, and 25% Remote job distribution, with an average salary of $91,011 per year, or $43.8 per hour.

Manager, Utilization Management Nursing

Humana

Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired 3 days ago. Applications are no longer accepted.

Humana rating

8.0

Company rating: 8.0 out of 10

Based on 267 frontline employees who took The Breakroom Quiz

170th of 315 rated insurance

Job description

Become a part of our caring community
The Manager, Utilization Management (UM) Nursing - LTSS utilizes clinical nursing expertise to lead and oversee Utilization Management operations supporting Long-Term Services and Supports (LTSS) members. The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals.
  • Uses clinical knowledge, communication skills, and independent critical thinking skills toward interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care, or services for Members
  • Ensure timely and accurate authorization creation and determinations in accordance with HFS, contractual, and regulatory requirements.
  • Lead and oversee Utilization Management Assistant Supervisors supporting LTSS populations.
  • Monitor Electronic Visit Verification (EVV) compliance and utilization trends to support quality and program integrity.
  • Monitor productivity, quality, utilization, and turnaround-time metrics.
  • Provide leadership and oversight of LTSS Utilization Management operations.
  • Provide operational oversight for LTSS covered services, authorization processes, productivity, quality, and compliance.
  • Hires, trains, coaches, counsels and evaluates performance of direct reports
  • Work collaboratively with UM leadership to assess and mitigate inefficiencies and provide solutions to improve clinical outcomes
  • Collects and analyzes data as necessary to drive operational metrics and associate performance
  • Collaborate with Care Management, Quality, Medical Directors, and operational partners.
  • Makes decisions that are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area
  • Facilitates cross departmental collaboration and conduct briefings and area meetings; maintains frequent contact with other managers across functional areas

Use your skills to make an impact

Required Qualifications

  • Licensed Registered Nurse in Illinois (IL), with no disciplinary action
  • Minimum 3 years of Utilization Management experience, preferably Medicaid Managed Care and/or LTSS including leadership of supervisors or team leads.
  • Previous experience in utilization management
  • Must be passionate about contributing to an organization focused on continually improving Member experiences

Preferred Qualifications

  • BSN, Bachelor's degree in Health Services, Healthcare Administration, or Business Administration
  • Prior management experience
  • Health Plan experience
  • Prior Medicare / Medicaid experience
  • Bilingual
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


$94,900 - $130,500 per year


This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.


Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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About Humana

Sourced by ZipRecruiter

Humana Inc., headquartered in Louisville, KY., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Louisville, KY, US

Year founded

1961

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