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Full Time Utilization Management Jobs (NOW HIRING)

UHS

Utilization Management Specialist

Plymouth, IN

Responsibilities Utilization Management Specialist - Full-time Michiana Behavioral Health (a UHS facility) Michiana Behavioral Health offers respectful, dignified care to adults, children and teens ...

UHS

Utilization Management Specialist

Plymouth, IN

Responsibilities Utilization Management Specialist - Full-time Michiana Behavioral Health (a UHS facility) Michiana Behavioral Health offers respectful, dignified care to adults, children and teens ...

UHS

Utilization Management Specialist

Plymouth, IN

Responsibilities Utilization Management Specialist - Full-time Michiana Behavioral Health (a UHS facility) Michiana Behavioral Health offers respectful, dignified care to adults, children and teens ...

UHS

Utilization Management Specialist

Plymouth, IN · On-site

Responsibilities Utilization Management Specialist - Full-time Michiana Behavioral Health (a UHS facility) Michiana Behavioral Health offers respectful, dignified care to adults, children and teens ...

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Full Time Utilization Management information

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$39K

$89.5K

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How much do full time utilization management jobs pay per year?

As of May 29, 2026, the average yearly pay for full time utilization management in the United States is $89,483.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,500.00 and $104,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Full Time Utilization Management professional, and why are they important?

To thrive in Full Time Utilization Management, you need a background in healthcare (often as an RN or other clinical license), strong knowledge of medical necessity criteria, and familiarity with insurance guidelines. Expertise in case management software, electronic health records (EHRs), and certifications such as Certified Case Manager (CCM) or Accredited Case Manager (ACM) are typically required. Attention to detail, critical thinking, effective communication, and negotiation skills help you advocate for appropriate patient care while managing costs. These skills ensure efficient resource allocation, compliance with regulations, and optimal patient outcomes within healthcare organizations.

How does a Full Time Utilization Management role typically interact with clinical and administrative teams?

In a Full Time Utilization Management position, you will regularly collaborate with both clinical staff, such as physicians and nurses, and administrative teams, like case managers and billing specialists. Your main responsibility is to review patient care requests, ensure services are medically necessary, and coordinate approvals or denials based on established guidelines. Effective communication and teamwork are essential, as you’ll often facilitate discussions between departments to optimize patient outcomes and resource use. This collaborative environment helps you build a broad understanding of healthcare processes and strengthens your problem-solving skills.

What is Utilization Management in a full-time position?

Utilization Management (UM) in a full-time role involves evaluating the necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities. Professionals in this field, often nurses or healthcare administrators, review patient cases, coordinate with healthcare providers, and ensure that care meets established guidelines while controlling costs. Their goal is to optimize patient outcomes by ensuring the right level of care is provided at the right time, while also helping organizations comply with regulations and insurance requirements.

What is the difference between Full Time Utilization Management vs Utilization Review Nurse?

AspectFull Time Utilization ManagementUtilization Review Nurse
CredentialsRN license, certifications in case management or utilization reviewRN license, certifications in utilization review or case management
Work EnvironmentTypically full-time, office-based, healthcare organizationsOften part-time or per review, hospital or insurance settings
Employer & IndustryHealth insurance companies, healthcare providersHospitals, insurance companies, third-party review organizations

Full Time Utilization Management professionals oversee the entire utilization review process, often in a full-time capacity, focusing on managing patient care and resource utilization. Utilization Review Nurses perform specific review tasks, usually on a case-by-case basis, and may work part-time or per review. Both roles require RN licensure and related certifications, but Full Time Utilization Management roles involve broader responsibilities and continuous oversight.

What cities are hiring for Full Time Utilization Management jobs? Cities with the most Full Time Utilization Management job openings:
What are the most commonly searched types of Utilization Management jobs? The most popular types of Utilization Management jobs are:
What states have the most Full Time Utilization Management jobs? States with the most job openings for Full Time Utilization Management jobs include:
Full Time Utilization Management jobs near you

Utilization Review Specialist - Care Management (Full Time) - 8033

Marshall Health Network

Huntington, WV • On-site

Full-time

Posted 14 days ago

Job description

St. Mary's Medical Center is seeking a Full Time Utilization Review Specialist for our Care Management Department. The Utilization Review Manager exercises independent judgement and professional discretion in the practice of case management to patients. The URS collaborates with physicians to ensure that patients are at the appropriate level of care with use of clinical based guidelines such as InterQual/MCG. The URS monitors continuing stay to protect solving skills to meet the needs of the patients and physicians while meeting the contractual guidelines of our payers.
Education Requirements:
Graduate of an approved school of nursing; holds and maintains current Registered Nursing License for the state of West Virginia.
BSN, Master Degree preferred, not required.
Experience:
Five years nursing experience. Minimum experience includes: patient care in the hospital setting, direct knowledge of care management, discharge planning and resource management.
Certifications/Skills:
Certifications in Care Management preferred, not required. BLS required

About Marshall Health Network

Sourced by ZipRecruiter

Marshall Health Network, Inc. is a West Virginia-based not-for-profit academic health system that includes the Marshall Health physician practice; Cabell Huntington Hospital, St. Mary’s Medical Center, Hoops Family Children’s Hospital, HIMG and Rivers Health. We are committed to improving the health and well-being of over one million children and adults in 38 counties in West Virginia, southern Ohio and eastern Kentucky through understanding, respecting and meeting their needs. Introducing Marshall Health Network Marshall Health Network is an academic health system with a visionary approach to healthcare. By aligning our goals under the Marshall Health Network banner, we are able to address healthcare disparities and public health issues while ensuring the latest medical research and clinical trials are available to our patients. We strive for consistency, clarity and character in healthcare. Compassion, quality and collaboration are key. That’s the Power of We.

Industry

Outpatient health care

Company size

11 - 50 Employees

Headquarters location

Huntington, WV, US

Year founded

2024

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